From the Guidelines
Antihypertensive medications can be administered to a 15-year-old adolescent with confirmed hypertension, defined as blood pressure consistently ≥95th percentile for age, sex, and height or ≥130/80 mmHg, under careful medical supervision. The decision to start medication depends on the severity of hypertension, underlying causes, and whether lifestyle modifications have been tried first, as recommended in the 2024 standards of care in diabetes 1.
Key Considerations
- Lifestyle modification focused on healthy nutrition, physical activity, sleep, and weight management should be the initial approach for treating elevated blood pressure in adolescents, including those aged 15 years 1.
- ACE inhibitors or angiotensin receptor blockers are recommended to be started in addition to lifestyle modification for the treatment of confirmed hypertension in adolescents aged ≥13 years, with the goal of achieving blood pressure <90th percentile for age, sex, and height or <130/80 mmHg 1.
- Individuals of childbearing age should receive reproductive counseling due to the potential teratogenic effects of ACE inhibitors and angiotensin receptor blockers, and these medications should be avoided in those not using reliable contraception 1.
Medication and Monitoring
- Common medications prescribed for adolescents with hypertension include ACE inhibitors and angiotensin receptor blockers, with dosing typically started at the lower end of the range and adjusted based on response.
- Before starting medication, the teen should have confirmed hypertension through multiple readings and appropriate screening for secondary causes.
- Lifestyle modifications should always accompany medication, including maintaining a healthy weight, regular physical activity, reduced sodium intake, and adequate sleep.
- Blood pressure medications in adolescents require regular monitoring for effectiveness and potential side effects, which may differ from adults, to prevent long-term cardiovascular complications and target organ damage.
From the FDA Drug Label
Pediatric Patients 6 years of age and older with hypertension For pediatric patients with glomerular filtration rate > 30 mL/min/1.73m2, the recommended starting dose is 0. 07 mg per kg once daily (up to 5 mg total). Antihypertensive effects and safety of lisinopril have been established in pediatric patients aged 6 to 16 years [see Dosage and Administration (2.1) and Clinical Studies (14. 1)].
Lisinopril can be administered to a 15-year-old adolescent for the treatment of hypertension, as the established age range for antihypertensive effects and safety is 6 to 16 years. The recommended dose should be determined based on the patient's weight and glomerular filtration rate, as outlined in the dosage and administration section 2.
From the Research
Antihypertensive Medications for Adolescents
- The provided studies do not specifically address the administration of antihypertensive medications to 15-year-old adolescents 3, 4, 5, 6, 7.
- The studies discuss the use of antihypertensive medications in adults, including combination therapy and the selection of appropriate medications based on patient characteristics and medical history 3, 4, 5, 7.
- One study discusses the treatment of hypertension in women of child-bearing age and during pregnancy, but it does not specifically address the use of antihypertensive medications in adolescents 6.
- The studies do not provide guidance on the safety and efficacy of antihypertensive medications in adolescents, and therefore, it is not possible to determine whether these medications can be administered to a 15-year-old adolescent based on the provided evidence.
Relevant Studies
- A study on combination antihypertensive drugs recommends the use of beta blockers or diuretics as first-line therapy for hypertension in adults 3.
- A study on the treatment of hypertension in women of child-bearing age and during pregnancy discusses the use of antihypertensive medications in this population, but it does not address the use of these medications in adolescents 6.
- Studies on the evaluation of antihypertensive medications, including amlodipine, lisinopril, and combination therapy, discuss the efficacy and safety of these medications in adults, but not in adolescents 4, 5, 7.