In last season’s podcast on pediatric hypertension, we discussed the initial diagnosis and lifestyle management of hypertension in pediatric patients. If you have not had the opportunity to listen to that episode, you can go back and listen to Season 2, episode 36. It will set the backdrop for today’s discussion as we dive more specifically into medication management for pediatric hypertension patients.
Listen to pediatric experts discuss their approach to hypertension medications
In this episode, we discuss medication management for pediatric hypertension patients with a pediatric cardiologist, Steve Daniels, MD, PhD and a clinical pharmacist, Dr. Megan Greene.
Dr. Greene is a pediatric clinical pharmacist in our Pediatric Hypertension Clinic at Children’s Hospital Colorado. She also has a specialization in critical care and kidney and liver transplant pharmaceutical support.
Dr. Daniels is the Pediatrician-in-Chief at Children’s Colorado. He is also the L. Joseph Butterfield Chair of Pediatrics within the University of Colorado School of Medicine, where he is a professor of pediatrics and epidemiology. Dr. Daniels is a recognized expert in the fields of pediatric hypertension, dyslipidemia and pediatric nutrition.
See Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents in Pediatrics from the AAP.
In this episode, our experts discuss:
- Dr. Daniels’ contribution to the recently released guidelines on pediatric hypertension
- Approaching consultations with patients who have been referred by their pediatricians
- Understanding the patient’s history and categorizing previous blood pressure measurements
- Why specialists must retest blood pressure in their own clinic setting
- Considerations before implementing more aggressive management of hypertension
- The uses of ambulatory blood pressure monitoring and navigating white coat hypertension
- Using the echocardiogram to measure left ventricular hypertrophy
- First-line medications, the starting doses, ACE inhibitors and ARBs
- Doing baseline renal function labs before administering medication and thoughts on diuretics
- Important discussions with families, including the risk for cardiovascular disease
- Limiting side effects of ACE inhibitors, starting with low doses and when to switch to ARBs
- Keeping in mind that ACE inhibitors and ARBs are contraindicated in pregnancy
- The issue of adherence to medication: an important consideration with pediatric patients
- The cost of medication and finding creative ways to make treatment more affordable
- Why pediatric hypertension should be thought of as a primary care issue
- The various benefits of treating hypertension, including improved neurocognition
Treatment of pediatric hypertension at Children’s Colorado
Our Pediatric Heart Lung Center at Children’s Colorado is a multidisciplinary program that provides a unique approach toward patient care, education, research and training in childhood heart and lung disease. Today, Children's Colorado is involved in almost every clinical trial of new medications for children with pediatric hypertension. We see more, treat more and heal more children than any hospital in our seven-state region.
Refer a patient to Children’s Colorado.