Allopurinol enhances the blood pressure lowering effect of enalapril in children with hyperuricemic essential hypertension

Essential hypertension is frequently associated with hyperuricemia in both adult and pediatric patients. Lowering serum uric acid level may provide greater benefit than simply treating hypertension. Forty-four adolescents, aged 12-19 years, newly diagnosed as essential hypertension (secondary hypertension was excluded) and previously untreated were randomized (open label trial) to receive either enalapril or enalapril plus allopurinol in combination. All participants had baseline serum uric acid level a parts per thousand yen5.5 mg/dl. Baseline mean blood pressure (BP), age and body mass index were similar between the two groups. After 8 weeks' treatment, BP reduction was greater, percent of treatment group achieving target BP level was greater, and serum uric acid level was lower in the combination treatment group. There were no adverse effects during the course of therapy. Results suggest that uric acid reduction may be used as adjunctive antihypertensive therapy in hypertensive adolescents with hyperuricemia while closely monitoring for any adverse effect.