CORRESPONDENCE
Propranolol efficacy in essential hypertension in adolescents To the editor: Propranolol is of proven usefulness in selected cases of essential hypertension in adults; whether essential hypertension in adolescents would respond as well or even better to /3adrenergic blocking therapy was not known. We therefore conducted in 10 hypertensive adolescents a single-blind, crossover, 8-month trial of propranolol and placebo - the first such study to our knowledge. The five boys and five girls, aged 14 to 17 years, had essential hypertension according to the following criteria: blood pressure readings repeatedly above the 90th percentile for their age and sex,1 normal renal function, normal results of rapid-sequence intravenous pyelography, normal values of serum electrolytes and urinary vanillylmandelic acid, and at least one hypertensive parent. All 10 patients were seen at approximately 2-week intervals for 8 months at an outpatient clinic. Four were randomly assigned to a propranolol-placebo sequence of therapy and the other six to a placebo-propranolol sequence. Each treatment period lasted 4 months. The daily maintenance dose of propranolol ranged from 90 to 240 mg. The mean blood pressure readings and heart rates at the last visit of each treatment period are summarized ir. Table I. A significant effect from /3blocking therapy was evident for each of the three types of readings. Furthermore, there was a significant, strongly positive correlation between systolic blood pressure at the end of placebo therapy and the decrease in systolic Contributions to the Correspondence section are welcomed and if considered suitable will be published as space permits. They should be typewritten double spaced and, except for case reports, should not exceed 1½ pages in length.
indicating that there is no residual, carry-over effect even after 4 months of continuous p3-blockade. It is possible that if p-blockade were continued for a few years at this critical stage in the development of essential hypertension, these patients might enter adulthood with normal blood pressure.2 Until this "reversal" hypothesis is convincingly substantiated, the use of propranolol in the treatment of uncomplicated, benign essential hypertension in children and adolescents remains experimental. We conclude that propranolol is a potent agent for treating adolescents with essential hypertension and that the response is proportional to the baseline elevation in blood pressure.
blood pressure by the end of propranolol therapy (r 0.84; P < 0.005). A similar correlation was observed for the diastolic blood pressure (r = 0.95; P
Propranolol efficacy in essential hypertension in adolescents To the editor: Propranolol is of proven usefulness in selected cases of essential hypertension in adults; whether essential hypertension in adolescents would respond as well or even better to /3adrenergic blocking therapy was not known. We therefore conducted in 10 hypertensive adolescents a single-blind, crossover, 8-month trial of propranolol and placebo - the first such study to our knowledge. The five boys and five girls, aged 14 to 17 years, had essential hypertension according to the following criteria: blood pressure readings repeatedly above the 90th percentile for their age and sex,1 normal renal function, normal results of rapid-sequence intravenous pyelography, normal values of serum electrolytes and urinary vanillylmandelic acid, and at least one hypertensive parent. All 10 patients were seen at approximately 2-week intervals for 8 months at an outpatient clinic. Four were randomly assigned to a propranolol-placebo sequence of therapy and the other six to a placebo-propranolol sequence. Each treatment period lasted 4 months. The daily maintenance dose of propranolol ranged from 90 to 240 mg. The mean blood pressure readings and heart rates at the last visit of each treatment period are summarized ir. Table I. A significant effect from /3blocking therapy was evident for each of the three types of readings. Furthermore, there was a significant, strongly positive correlation between systolic blood pressure at the end of placebo therapy and the decrease in systolic Contributions to the Correspondence section are welcomed and if considered suitable will be published as space permits. They should be typewritten double spaced and, except for case reports, should not exceed 1½ pages in length.
indicating that there is no residual, carry-over effect even after 4 months of continuous p3-blockade. It is possible that if p-blockade were continued for a few years at this critical stage in the development of essential hypertension, these patients might enter adulthood with normal blood pressure.2 Until this "reversal" hypothesis is convincingly substantiated, the use of propranolol in the treatment of uncomplicated, benign essential hypertension in children and adolescents remains experimental. We conclude that propranolol is a potent agent for treating adolescents with essential hypertension and that the response is proportional to the baseline elevation in blood pressure.
blood pressure by the end of propranolol therapy (r 0.84; P < 0.005). A similar correlation was observed for the diastolic blood pressure (r = 0.95; P
