ESPN 54th Annual Meeting

ESPN 2022


 
Pharmacological treatment of arterial hypertension in children and adolescents in Lithuania
DOVILE RUZGIENE 1 ELEONORA IVANOVA 2 AUGUSTINA JANKAUSKIENE 1

1- PEDIATRIC CENTER, INSTITUTE OF CLINICAL MEDICINE, VILNIUS UNIVERSITY
2- VILNIUS UNIVERSITY, FACULTY OF MEDICINE
 
Introduction:

 The prevalence of arterial hypertension (AH) in pediatric population in Europe ranges from 2.2% to 13% and even more in overweight or obese children. Part of these patients receives pharmacological treatment. The aim of the study was to evaluate the pharmacological treatment of children and adolescents in Lithuania and to compare the treatment choices in 2015 – before the release of 2016 European Society of Hypertension guidelines for the management of high blood pressure (BP) in children and adolescents and after – in 2019.

Material and methods:

 Big data was extracted from Lithuanian National Health Insurance Fund database for prescriptions covered by insurance for children from 0 to 17 years of age in the year of 2015 and 2019 for primary and secondary AH. Patients were divided in 0-3, 4-7, 8-12, 12-17 age groups. Antihypertensive medications were grouped by their pharmacological class: angiotensin converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARBs), beta blockers (BB), calcium channel blockers (CCB), diuretics, imidazoline receptor agonists, alpha-blockers, combined ACEi and diuretics. 

Results:

 1382 prescriptions were done in 2015 and 1233 in 2019 for AH. ACEi were the first choice for primary and secondary AH in all age groups, while BB were in the second place. ARBs were the third or the fourth choice depending on the age group. Enalapril was the most common in ACEi group, while Metoprolol in BB. The pharmacological treatment options did not differ in compared years. 

Conclusions:

 BB are used more often as antihypertensive agents than they should be, while ARBs are underused. There was no difference between primary and secondary AH treatment. No difference in pharmacological AH treatment was made after the release of 2016 BP guidelines.