OBJECTIVES: To assess the use of angiotensin receptor blockers (ARBs) in the European Union (EU) pediatric patients experiencing essential hypertension. METHODS: This was a retrospective analysis of the IMS MIDAS Prescribing Insight Medical database. Projected prescription data for pediatric patients (<18 years) in the time period of October 2005 to September 2006 were analyzed. Five major European markets including France, Germany, Italy, Spain and the UK were studied for the usage of ARBs as either a monotherapy or fixed-dose combination therapy (FDC). Pediatric patients with essential hypertension were identified using ICD-10 codes. The ATC classification was used to identify major classes of antihypertensives. During analysis, special emphasis was placed on the 6-17 years age category, as many ARBs were recommended in children above 6 years of age. RESULTS: Out of 242,405 estimated pediatric patients with hypertension, 222,033 (91.6%) were diagnosed with essential hypertension. Out of 230,220 projected prescriptions dispensed to these essential hypertensives, 76.2% were for patients in the 6-17 years age group. In that age group, ARBs constituted 25.5% of the projected prescriptions with 10.6% in the form of FDC of ARBs with hydrochlorothiazides (HCTz). Diuretics also were used in 11.6% of the pediatric population in the age range of 6-17 years. ARBs usage, either as a monotherapy or as a FDC with HCTz, was higher in Italy (35.7%), France (30.9%) and Spain (28.1%) but was lower in Germany (5.3%) and non-existent in the UK. Valsartan-based and losartan-based FDCs were commonly used in the age range of 6-17 years and accounted for 39.1% and 13.9% of the projected prescription volume in the ARB-FDC category, respectively. CONCLUSION: In a majority of the key EU markets, pediatric hypertensive patients in the age range of 6-17 years are regularly treated with ARB monotherapy or FDC therapy, often without supportive clinical efficacy studies.