Isradipine for Treatment of Acute Hypertension in Hospitalized Children and Adolescents
Article first published online: 5 NOV 2010
© 2010 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 12, Issue 11, pages 850–855, November 2010
How to Cite
Miyashita, Y., Peterson, D., Rees, J. M. and Flynn, J. T. (2010), Isradipine for Treatment of Acute Hypertension in Hospitalized Children and Adolescents. The Journal of Clinical Hypertension, 12: 850–855. doi: 10.1111/j.1751-7176.2010.00347.x
- Issue published online: 5 NOV 2010
- Article first published online: 5 NOV 2010
- Manuscript received February 1, 2010; accepted March 21, 2010
J Clin Hypertens (Greenwich).
Severe acute hypertension in pediatric patients requires prompt and controlled blood pressure (BP) reduction to prevent end-organ damage. The authors aimed to examine the efficacy and safety of isradipine, an orally administered second-generation dihydropyridine calcium channel blocker, for treatment of acute hypertension in hospitalized pediatric patients. A retrospective analysis of 391 doses of isradipine administered to 282 patients (58% boys) with acute hypertension and median age of 12.8 years (range, 0.1–21.9) was performed. Primary diagnoses included renal disease (n=154), malignancy (45), nonrenal transplant (37), neurologic disease (21), and other (25). The decrease in systolic BP was 16.3%±11.6% (mean ± SD) and diastolic BP was 24.2%±17.2%. BPs were significantly lower in all age groups and in all diagnosis categories following isradipine administration. The decrease in BP was the highest in children younger than 2 years. The mean increase in pulse after a dose was 7±17 beats per minute. Forty adverse events were reported in 33 patients, with emesis and nausea being the most common; 5 of these events were hypotension. The authors conclude that isradipine effectively reduces BP in a wide variety of hospitalized children and adolescents with acute hypertension. A lower initial dose of 0.05 mg/kg may be appropriate in children younger than 2 years. J Clin Hypertens (Greenwich). 2010;12:850–855.