Many children with hypertension, particularly those with new-onset hypertension 
related to glomerulonephritis, organ transplantation, or other forms of 
secondary hypertension, require treatment with a short-acting antihypertensive 
in order to quickly achieve blood pressure (BP) control. We administered 
isradipine, a short-acting, second-generation calcium antagonist, to 72 such 
children. Retrospective data collection was undertaken to determine the effects 
of isradipine treatment. The mean age of children treated with isradipine was 
74+/-55 months (mean+/-SD). Nearly all of these children had secondary 
hypertension and were initially treated as hospital inpatients for newly 
diagnosed hypertension. Mean isradipine dose was 0.36+/-0.17 mg/kg per day, with 
no significant variation in dose according to patient age. Isradipine was 
administered three times per day in most instances, but 21% of the time it was 
administered four times per day. An extemporaneous isradipine suspension was 
used in 62% of treatment courses. BP control was achieved with isradipine alone 
in 38 children; the remainder received isradipine in combination with additional 
antihypertensives. Comparison of pre-treatment BP with BP obtained 8+/-9 days 
later demonstrated a significant BP reduction with isradipine treatment, with a 
mean reduction of 14+/-13 mmHg for systolic BP and 13+/-15 mmHg for diastolic 
BP. There was no effect of isradipine treatment on heart rate. Adverse effects 
occurred in 9.5% of treatment courses, and included headache, flushing, 
dizziness, and tachycardia. We conclude that isradipine successfully lowers BP 
in hypertensive children with secondary forms of hypertension. Use of isradipine 
suspension allows infants and young children to be treated as readily as older 
children.