ISRADIPINE THERAPY IN HYPERTENSIVE PEDIATRIC-PATIENTS

OBJECTIVE: To evaluate the dosage and effectiveness of isradipine to c ontrol acute or chronic hypertension in pediatric patients. DESIGN: Re trospective medical record review. SETTING: University teaching hospit al. PARTICIPANTS: Hospitalized pediatric patients aged 1 day to 16 yea rs with hypertension treated with isradipine between January 1994 and March 1996. MEASURES: Patient age, gender, weight, disease states, cur rent medications, isradipine dosage and formulation, pre- and postsyst olic, and pre- and postdiastolic blood pressure measurements with each dose of isradipine. RESULTS: 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 t he values recorded after the last dose or at discharge for all patient s was -11.8% +/- 12.5% and -17.4% +/- 19.6%, respectively, for systoli c and diastolic pressure. The mean dosage of isradipine in 46 patients who received regularly scheduled doses was 0.38 +/- 0.22 mg/kg/d. Pat ients 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. CONCLUSIONS: Isradipine was an effective an tihypertensive agent to reduce the systolic and/or diastolic blood pre ssure 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, m ost frequently administered in two or three equally divided doses, whi ch is higher than the normal recommended dosage for adults.