The use of short-acting nifedipine in pediatric patients with hypertension.
OBJECTIVE
To evaluate the use of short-acting nifedipine for treatment of severe hypertension in children.


METHODS
A retrospective chart review of 520 nifedipine doses given for severe hypertension in 117 pediatric patients was completed. Nifedipine dose, systolic and diastolic blood pressures before and within 2 hours of the dose, and side effects were recorded. Pre- and post-dose mean arterial pressure (MAP) and percent reductions in MAP and systolic and diastolic blood pressure were calculated. Age, dose, primary diagnosis, and use of other antihypertensive agents were examined with respect to blood pressure reduction.


RESULTS
Of the doses received, 35% were associated with > or =25% reduction in MAP, a degree of MAP reduction previously associated with hypertension treatment complications. MAP percent reduction was correlated with nifedipine dose adjusted for weight (r = 0.24, P<.001). Mean nifedipine doses per kilogram were larger in patients who had > or =25% MAP reduction compared with those who had <25% MAP reduction (0.26 +/- 0.12 mg/kg vs. 0.21 +/- 0.11 mg/kg, F = 29.01, P <.001). Adolescents received lower nifedipine doses per kilogram and had lower percent reduction in blood pressure compared with younger children. No clinically significant side effects were noted after administration of nifedipine.


CONCLUSIONS
Precipitous reductions in blood pressure are ameliorated by decreasing the initial nifedipine dose to < or =0.25 mg/kg in pediatric patients. Short-acting nifedipine use in pediatric patients with hypertension in a hospital setting is safe.
Blaszak
R T
RT
Arkansas Children's Hospital and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA.
Savage
J A
JA
Ellis
E N
EN
D000293:Adolescent; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D006977:Hypertension, Renal / Q000188:drug therapy; D008297:Male; D009543:Nifedipine / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors
D000959:Antihypertensive Agents; D009543:Nifedipine