Treatment of hypertensive children with amlodipine

Amlodipine, a long-acting dihydropyridine calcium channel blocking agent, w as administered to 55 children (age: 11.5 +/- 5.4 years) with hypertension, 49 of whom (89%) had secondary hypertension. Efficacy was assessed by comp aring pretreatment blood pressure (BP) to follow-up BP obtained in our outp atient Pediatric Nephrology clinic. Thirty-two (58%) patients achieved BP control with amlodipine alone, and 31 (55%) patients received amlodipine twice daily. Eleven patients received a mlodipine as a suspension. Mean amlodipine dose was 0.16 +/- 0.12 mg/kg/day ; there was an inverse relationship between patient age and amlodipine dose . Follow-up BP were significantly lower than pretreatment BP: systolic BP f ell from 129 +/- 12 to 122 +/- 12 mm Hg (P =.004), and diastolic BP fell fr om 78 +/- 13 to 70 +/- 19 mm Hg (P =.003). A small, clinically insignifican t increase in heart rate (from 91 +/- 19 beats/min to 99 +/- 26 beats/min; P =.02) occurred during amlodipine treatment. Adverse effects reported incl uded dizziness (three patients), fatigue (two patients), hushing (two patie nts), and (eg edema tone patient). All improved with dose reduction. We conclude that amlodipine provides effective BP control without significa nt adverse effects in children with hypertension, and can be used as monoth erapy in most children. Young children appear to require significantly high er doses per kilogram of body weight than older children. Twice-daily dosin g may be required in many children to achieve BP control. Detailed pharmaco kinetic studies are needed to confirm these observations. Am J Hypertens 20 00; 13:1061-1066 (C) 2000 American Journal of Hypertension, Ltd.