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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Obstetric and Pediatric Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1425863
This article is part of the Research Topic Precision Medicine in Pediatrics - Volume II View all 12 articles

Plasma calcitonin gene-related peptide and nitric oxide predict therapeutic response to amlodipine in pediatric primary hypertension

Provisionally accepted
Hui Wang Hui Wang 1,2Yao Lin Yao Lin 1Yuting Wang Yuting Wang 1,2Shen Chen Shen Chen 1Yaqi Li Yaqi Li 1Liu Yang Liu Yang 1Lin Shi Lin Shi 1,2*
  • 1 Children's Hospital of Capital Institute of Pediatrics, Beijing, Beijing Municipality, China
  • 2 Peking Union Medical College Graduate School, Beijing, China

The final, formatted version of the article will be published soon.

    Background: There is a lack of suitable predictive markers for assessing the efficacy of amlodipine in treating children with primary hypertension. This study aimed to explore whether plasma calcitonin gene-related peptide (CGRP) and nitric oxide (NO) could predict the effectiveness of amlodipine in pediatric primary hypertension.Methods: This study enrolled 74 children and adolescents with primary hypertension who were prescribed amlodipine monotherapy, and after 4 weeks of treatment, they were divided into responders and non-responders according to blood pressure. Baseline data differences between the two groups were analyzed, followed by binary logistic regression to assess the correlation between significant variables and therapeutic efficacy. The receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy, and the nomogram model was established to predict therapeutic response to amlodipine.The responders exhibited lower body mass index, C-peptide and plasma CGRP levels, and higher NO levels compared to the non-responders (P < 0.05). Multivariable logistic analysis revealed that plasma CGRP and NO were independently associated with the therapeutic response to amlodipine, showing a higher predictive performance when used in combination (AUC: 0.814, 95% CI 0.714-0.914) with a predictive sensitivity of 86.5% and specificity of 70.1%. The nomogram model displayed good calibration, and the decision curve analysis indicated this model led to net benefits in a wide range of threshold probability.CGRP and NO may be valuable biomarkers for predicting amlodipine effectiveness in the treatment of pediatric primary hypertension, while the nomogram model indicates excellent predictive value.

    Keywords: Amlodipine, efficacy, biomarker, Primary hypertension, Children

    Received: 30 Apr 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Wang, Lin, Wang, Chen, Li, Yang and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Lin Shi, Children's Hospital of Capital Institute of Pediatrics, Beijing, 100005, Beijing Municipality, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.