Keywords: elderly, hypertension, HYVET, older adults, treatment In the pilot study, subjects aged over 80 years, with a sustained blood. Kardiol Pol. Jul;66(7); discussion [HYVET study – treatment for hypertension]. [Article in Polish]. Zalewska J(1). Author information. “In the main HYVET study, we aimed to resolve persistent areas of clinical uncertainty about the relative benefits and risks of antihypertensive.
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The s saw publication of landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ]. Those on antihypertensives at baseline had their medications stopped prior to placebo run-in. Treating very elderly hypertensive patients is rewarding: Immediate and late benefits of treating very elderly people with hypertension: Association of depression with subsequent mortality, cardiovascular morbidity and incident dementia in people aged 80 and over and suffering from hypertension.
The investigators also observed a non-significant reduction in the primary outcome measure, stroke, unadjusted hazard ratio HR 0.
This may hyvwt the relative physical well being of the trial population [ 24 ]. The initial inclusion criteria demanded both systolic and diastolic hypertension SDH mean systolic BP — mmHg; mean diastolic Hyvte 90— mmHgoff treatment, during a 2 month run in period. A meta-analysis of RCT data found that treatment of hypertension in this age group was associated with a statistically significant reduction in major CV events and HF but no reduction no CV mortaltiy and an increased risk of all-cause mortality.
In addition, it was notable that four centres closed in the first year due to data quality issues [ 13 ].
[HYVET study – treatment for hypertension].
The trial steering group also published an analysis evaluating the association of depression with cardiovascular mortality and morbidity, all-cause mortality and incident dementia. Equally, at the time of the second interim analysis July the relative risk of all stroke fatal and non-fatal amongst those receiving active treatment was 0. N Engl J Med. The role of blood pressure control in preventing complications of hypertension.
Br J Clin Pharmacol. National Center for Biotechnology InformationU. This treatment regimen was also found to be associated with a large and significant reduction in heart failure, whilst proving particularly efficacious in the management of isolated systolic hypertension. Moreover, active treatment was well tolerated. A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults.
There were also significant reductions in rates of other secondary outcomes including fatal stroke, HF, and CV events. Allowing for all fractures, regardless of whether they were incident, validated fractures or not, resulted in an adjusted HR of 0. The New England Journal of Medicine.
The Hypertension in the Very Elderly Trial – latest data
Hypertension — treated and untreated. After a 2-month placebo run-in phase, 3, patients were randomized to active treatment or placebo with stratification according to age and sex. Antihypertensive drugs in very old people: Once again, the relative well hyveh of the trial participants limits the potential applicability of these data to the general population.
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Five-year hyget of the hypertension Detection and Follow-up Program: Again, differences were seen for all-cause mortality 47 deaths; HR 0. Despite this, a trend analysis from the EWPHE trial suggested that the treatment of hypertension might be less effective or even harmful to the very old aged over 80 years [ 10 ].
The Hypertension in the Very Elderly Trial – latest data
This appeared to detect small differences between the two trial arms, in favour of treatment. However, with the passage of time, a progressive effort has been made to expand the evidence base for treatment in older adults.
Mortality by race-sex and age. Treatment of hypertension in the elderly.
This enhanced recruitment rates and led to the inclusion of subjects with isolated systolic hypertension ISH. Thus, no significant difference was observed between the two trial arms HR 0. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension.
All authors have completed the Unified Competing Interest form at http: In that vein, some have expressed significant concerns with over-treatment of hypertension in the elderly, citing the risks of polypharmacy and the fact that elderly patients are prone to hypovolemia and orthostatic syncope, etc.
In fact, serious adverse events SAEs were observed post-randomization in the placebo group. HYVET also has a number of methodological issues, namely the protocol amendment which provided for the inclusion of subjects with ISH and the variable methods for measuring blood pressure. Results of the pilot study for the hypertension in the very elderly trial.
Treatment of hypertension in patients 80 years of age or older. Initially blood pressures were recorded with either a mercury sphygmomanometer or a validated automated device, but at the end of the trial a validated automated device was used in the majority of centres [ 13 ].
In common with many other clinical trials in older people, the inclusion criteria also required that subjects be in relatively good physical and mental health individuals with dementia and those resident in nursing homes were excludedquestioning the applicability of the trial outcomes to the real life setting [ 1316 ]. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension.
More recently, additional data from this cohort has been published suggesting that appropriate anti-hypertensive therapy may lead to a reduction in incident cognitive impairment and fractures, whilst a 1 year open label extension of the main study confirmed many of the original trial findings.
Reduction in mortality of persons with high blood pressure, including mild hypertension. The primary outcome was the rate of fatal or nonfatal stroke excluding TIA.
Medical Research Council trial of treatment of hypertension in older adults: Author information Article notes Copyright and License information Disclaimer. Usable articles Nephrology Cardiology Geriatrics.