Is the extrapolated adult dose of fosinopril safe and effective in treating hypertensive children?

Published

Journal Article

We evaluated the efficacy, safety, and dose-response relationship of fosinopril in children aged 6 to 16 years with hypertension or high-normal blood pressure with an associated medical condition requiring treatment. The study was a prospective, double-blind, placebo-controlled trial conducted in 78 clinical sites in the United States, Russia, and Israel. There were 4 phases: a screening phase of 10 days maximum, a 4-week dose-response phase, a placebo withdrawal phase of 2 weeks maximum, and a 52-week open-label safety phase. The primary objective of the dose-response phase was to determine whether low (0.1 mg/kg), medium (0.3 mg/kg), or high (0.6 mg/kg) doses of fosinopril based on established adult dosing affect trough seated systolic blood pressure. During the dose-response phase, all 3 doses were equally effective in lowering systolic blood pressure. During the placebo withdrawal phase, there was an adjusted mean systolic blood pressure increase of 5.2 mm Hg for the placebo group and 1.5 mm Hg for the fosinopril group, a net withdrawal effect of 3.7 mm Hg (P=0.013). Fosinopril was well tolerated; serious adverse events occurred infrequently and were generally not attributed to fosinopril. Because children appear to be more sensitive to lower doses of fosinopril than adults, starting doses for children should be < or =0.1 mg/kg.

Full Text

Duke Authors

Cited Authors

  • Li, JS; Berezny, K; Kilaru, R; Hazan, L; Portman, R; Hogg, R; Jenkins, RD; Kanani, P; Cottrill, CM; Mattoo, TK; Zharkova, L; Kozlova, L; Weisman, I; Deitchman, D; Califf, RM

Published Date

  • September 2004

Published In

Volume / Issue

  • 44 / 3

Start / End Page

  • 289 - 293

PubMed ID

  • 15262902

Pubmed Central ID

  • 15262902

Electronic International Standard Serial Number (EISSN)

  • 1524-4563

Digital Object Identifier (DOI)

  • 10.1161/01.HYP.0000138069.68413.f0

Language

  • eng

Conference Location

  • United States