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.
|Country:||Antigua & Barbuda|
|Published (Last):||2 February 2016|
|PDF File Size:||16.94 Mb|
|ePub File Size:||5.32 Mb|
|Price:||Free* [*Free Regsitration Required]|
As a result, it remains unclear whether such benefits persist or diminish over a longer time course and although the hyevt criteria allowed for the enrolment of patients aged between 80 and years, most were 80 to 85 years old mean age; Influence of antihypertensive drug treatment on morbidity and mortality in patients over the age of 60 years.
Moreover, active treatment was well tolerated. Although waist circumference was not reported, hypertensive status was infrequently associated with other features of the metabolic syndrome in the trial population, aside from those subjects who had suffered a prior cardiovascular event [ 17 ].
This review provides an overview of the Hypertension in the Very Elderly Trial whilst also hyver evaluating the latest data. Conflict of interest statement All authors have completed the Unified Competing Interest form at http: Treating very elderly hypertensive patients is rewarding: The investigators also observed a non-significant reduction in the primary outcome measure, stroke, unadjusted hazard shudy HR 0. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension.
Medical Research Council trial of treatment of hypertension in older adults: Author information Article notes Copyright and License information Disclaimer. In addition, it was notable that four centres closed in the first year due to data quality issues [ 13 ].
Thus, the benefit of treatment above 85—90 years of age remains uncertain [ 1819 ].
HYVET – Wiki Journal Club
Although the model requires further validation, it suggests that studh change in those aged over 80 years is small, depends on baseline cognitive function and the relative efficacy of anti-hypertensive treatment [ 25 ]. Whilst a statistically significant reduction in congestive cardiac failure was also observed unadjusted HR 0.
Main study nyvet A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults. Reduction in mortality of persons with high blood pressure, including mild hypertension.
Usable articles Nephrology Cardiology Geriatrics. Once again, the relative well being of the trial participants limits the potential applicability of these data to the general population.
[HYVET study – treatment for hypertension].
Given this uncertainty, the Hypertension in the Very Elderly Trial HYVET was commissioned with an open label pilot undertaken to determine trial feasibility [ 1112 ]. Immediate and late benefits of treating very elderly people with hypertension: Subjects were then randomized to one of two treatment arms, the thiazide like diuretic, indapamide sustained release, 1. Treatment of hypertension in the elderly. Support Center Support Center. More importantly, the early evidence of mortality benefit resulted in a relatively short duration of follow-up median 1.
Five-year findings of the hypertension Detection and Follow-up Program: This enhanced recruitment rates and led to the inclusion of subjects with isolated systolic hypertension ISH. The trial steering group also published an analysis evaluating the association of depression with cardiovascular mortality and morbidity, all-cause mortality and incident dementia.
The optimal target BP among very elderly patients has yet to be defined. Again, differences were seen for all-cause mortality 47 deaths; HR 0.
This hypothesis, that indapamide a thiazide-like diuretic reduces urinary calcium excretion and as a result may reduce fracture rates, was tested in a sub-study.
Mancia G, Grassi G. Stepwise treatment consisted of a diuretic indapamide sustained release 1. Trial participants receiving double-blind treatment at their final visit within the main study were deemed eligible for inclusion.
Results in patients with diastolic blood pressures averaging through mm Hg. Initially stufy 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 ].
However, with the passage of time, a progressive effort has been made to expand the evidence base for treatment in older adults.
Formal education was protective HR 0. Those on antihypertensives at baseline had their medications stopped prior to placebo run-in. Br J Clin Pharmacol. There were also significant reductions in rates of other secondary outcomes including fatal stroke, HF, and CV events. Earlier this year, results from a 1 year open label active treatment extension of HYVET were published.
Whilst each additional GDS point at baseline also increased these risks, the study was not designed to hyvey this association.
The Hypertension in the Very Elderly Trial – latest data
The number of subjects who smoked cigarettes 2. Among very elderly patients with hypertension, does active treatment with antihypertensives reduce the rate of fatal or nonfatal stroke when compared with placebo?
Furthermore, standing and seated BPs post-treatment were equivalent, suggesting that antihypertensive therapy was not associated with orthostatic hypotension [ 13 ]. However, at the time of the final intention-to-treat analysis in Octoberthis significant reduction in the primary outcome measure failed to show statistical significance — the reasons for which have never been elaborated.
Effects of treatment on morbidity in hypertension. Given the log linear relationship between systolic blood pressure and clinical outcomes, the mortality and morbidity benefits seen in the trial might be a feature of systolic BP control, particularly in ISH, as opposed to achieved systolic and diastolic blood pressure. Treatment of hypertension in patients 80 years of age or older.
Antihypertensive drugs in very old people: At 2 years there were no significant changes in serum potassium, uric acid, glucose and creatinine between the trial arms [ 13 ].