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Antihypertensive medications are recommended for children who continue to have high blood pressure despite nutrition and lifestyle interventions and for those who have end organ damage. In this industry-supported, double-blind study, researchers randomized 144 children (age range, 6–16 years) diagnosed with primary hypertension to receive either placebo or one of three escalating doses (0.2, 1.0, or 2.0 mg/kg) of extended-release metoprolol, a cardioselective beta-blocker. Most participants were male, were overweight, and had isolated systolic hypertension. Patients with asthma and type 1 diabetes were excluded.
After 4 weeks of treatment, the reduction from baseline in sitting systolic blood pressure was significantly greater in those who r…