ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Cardiology
Pediatric Oral Antihypertensive Agents: Analysis of Prescription Patterns and Patient Characteristics in a Real-World Study
Provisionally accepted
- 1Capital Institute of Pediatrics, Beijing, China
- 2Capital Medical University, Beijing, China
- 3University of Washington, Seattle, United States
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Objectives: The aim of this study was to assess prescribing intensity and rational dosing of antihypertensives in children using Defined Daily Dose (DDD) and Drug Utilization Index (DUI). Methods: A retrospective cross-sectional analysis was conducted on all antihypertensive prescriptions dispensed at a tertiary children's hospital from May 2023 to April 2024, excluding those with incomplete data or on fixed-dose combinations. Prescription medicine use is basically reasonable when DUI is close to 1 (0.9-1.1), a DUI > 1.1 suggests that the actual daily dose exceeds DDD, while a DUI < 0.9 indicates underdosing. Statistical analysis was performed using SPSS 23.0 with significance at p < 0.05. Results: A total of 1,562 prescriptions for 422 children (12–18 y; 76.30 % male) were analysed; prevalence peaked at 13 y. Among over-12-year-olds, DUI <0.9 for β-blockers, spironolactone and nifedipine; DUI ≈1 for furosemide, captopril and losartan; DUI >1.1 for hydrochlorothiazide, amlodipine, ramipril and fosinopril. Amlodipine comprised 42.8 % of total DDDs, followed by fosinopril (25.6 %) and ramipril (20.0 %). Males showed borderline higher DUI values. Conclusions: Hypertension was most prevalent among 13-to 14-year-old, who also exhibited the highest antihypertensive exposure and drug-use intensity relative to girls. Once-daily formulations accounted for the majority of prescriptions. Pediatric oral hypertension dosing remains inconsistent in clinical practice. These findings support sex-specific management and guideline updates to improve blood pressure control in high-risk adolescents.
Keywords: Antihypertensive medicines, Children, Drug Utilization, Hypertension, Prescription
Received: 15 Dec 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Cheng, Cui, Ma, Wang, Zhong and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Haixin Cheng
Jianmin Zhang
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