Isradipine therapy in hypertensive pediatric patients

To evaluate the dosage and effectiveness of isradipine to control acute or chronic hypertension in pediatric patients.

Retrospective medical record review.

University teaching hospital.

Hospitalized pediatric patients aged 1 day to 16 years with hypertension treated with isradipine between January 1994 and March 1996.

Patient age, gender, weight, disease states, current medications, isradipine dosage and formulation, pre- and postsystolic, and pre- and postdiastolic blood pressure measurements with each dose of isradipine.

Fifty-three patients with a mean age of 5.8 +/- 4.0 years were evaluated. A mean change in the blood pressure measurements taken before the first dose of isradipine compared with the values recorded after the last dose or at discharge for all patients was -11.8% +/- 12.5% and -17.4% +/- 19.6%, respectively, for systolic and diastolic pressure. The mean dosage of isradipine in 46 patients who received regularly scheduled doses was 0.38 +/- 0.22 mg/kg/d. Patients who demonstrated a response received a mean dosage of 0.40 +/- 0.20 mg/kg/d. The total daily dosage was administered in one dose for 1 patient, two doses for 15 patients, three doses for 27 patients, and four doses for 3 patients.

Isradipine was an effective antihypertensive agent to reduce the systolic and/or diastolic blood pressure 10% or more compared with pretreatment measurements in 43 (81%) of 53 pediatric patients. The mean dosage was 0.38 +/- 0.22 mg/kg/d, most frequently administered in two or three equally divided doses, which is higher than the normal recommended dosage for adults.