Keywords: elderly, hypertension, HYVET, older adults, treatment Despite this, a trend analysis from the EWPHE trial suggested that the. The Hypertension in the Very Elderly Trial (HYVET) is a multicentre, open, randomised, controlled trial. The aim of this trial is to investigate the effect of active. Drugs Aging. ;18(3) Hypertension in the Very Elderly Trial (HYVET): protocol for the main trial. Bulpitt C(1), Fletcher A, Beckett N, Coope J.
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Also required is a standing systolic blood pressure of at least mm Hg. Abstract Early trials in the field of hypertension focused on adults in their fifties and sixties. Bulpitt noted, the number needed to treat was very low to prevent cardiovascular events: This may reflect the relative physical well being of the trial population [ 24 ].
This comes from the Hypertension in the Very Elderly Trial HYVET presented by Ruth PetersPhD of Imperial College, London, at the ESH Annual Conference which randomised 3, patients older than 80 years, all of whom had established hypertension which had already been previously treated in three quarters of them byvet receive active doublet or single agent antihypertensive medication or a placebo.
Trial participants receiving double-blind treatment at their hybet visit within the main study were deemed eligible for inclusion. Retrieved from ” http: He was anxious not to discourage teams from reducing pressures sufficiently, which he thought was generally very desirable for improving cardiovascular mortality rates in the very elderly.
Treatment of hypertension in patients 80 years of age or older. 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. Starting dosage for bendroflumethiazide and lisinopril is 2.
Those on antihypertensives at baseline had their medications stopped prior to placebo run-in. When the p value for trend with age was corrected for gender, there were still few significant differences from the trrial population.
Influence of antihypertensive drug treatment on morbidity and mortality in patients over the age of 60 years.
Hypertension in the Very Elderly Trial (HYVET): protocol for the main trial.
What limited data are available have raised concerns. Moreover, active treatment was well tolerated. National Center for Biotechnology InformationU. In addition, it was notable that gyvet centres closed in the first year due to data quality issues [ 13 ].
HYVET – Wiki Journal Club
These drugs have been chosen as inexpensive and appropriate representatives of their therapeutic classes. Once again, the relative well being of trlal trial participants limits the potential applicability of these data to the general population. Effects of treatment on morbidity in hypertension. Navigation menu Personal tools Create account Log in. All authors have completed the Unified Competing Interest form at http: The pilot phase of the trial has been started with support from the British Heart Foundation.
Earlier this year, results from a 1 year open label active treatment hyvt of HYVET were published. 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.
Furthermore, standing and seated BPs post-treatment were equivalent, suggesting that antihypertensive therapy was not associated with orthostatic hypotension [ 13 ].
Beckett NS, et al.
Dr Peter Sleight of Hjvet in the UK asked whether this was related to cerebrovascular events, but Dr Peters thought the sample size of patients in this group was insufficient to generate an answer from the HYVET data. Reduction in mortality of persons with high blood pressure, including mild hypertension. Entry criteria include a sustained sitting systolic blood pressure of to mm Hg plus a sustained sitting diastolic pressure of 95 to mm Hg.
More importantly, the early evidence of mortality benefit resulted in a relatively short duration of follow-up median 1. It is possible that the difference in stroke rates would have reached statistical significance had the trial not been stopped early. 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.
There was some triap during the session in Milan about whether this might be an artefact, however. The number of subjects who smoked cigarettes 2. Mancia G, Grassi G. Association of depression with subsequent mortality, cardiovascular morbidity and incident dementia in people aged 80 and over and suffering from hypertension. Formal education was protective HR 0.
Further Results of the Hypertension in the Very Elderly Trial (HYVET)
The study — the largest international, hyveg, placebo-controlled trial of its kind — concludes that very elderly patients with hypertension should be treated, and that this brings only benefits and not additional risks.
All participants were 80 years or older and had persistent hypertension defined as systolic BP of at least mm Hg. Results in patients with diastolic blood pressures averaging through mm Hg.
However, with the passage of time, a progressive effort has been made to expand the evidence base for treatment in older adults. The primary endpoint of HYVET was any fatal or nonfatal stroke, with secondary endpoints including all-cause mortality, cardiovascular mortality, cardiac death, and death from stroke. The aim of this trial is to investigate the effect of active treatment on stroke incidence in hypertensive patients over the age of 80 years. Five-year findings of the Hypertension Detection and Follow-up Program: Early trials in the field of hypertension focused on adults in their fifties and sixties.
Although the model requires further validation, it suggests that cognitive change in those aged over 80 years is small, depends on baseline cognitive function and the relative efficacy of anti-hypertensive treatment [ 25 ]. Conflict of interest statement All authors have completed the Unified Competing Interest form at http: However, while treatment conferred considerable benefits on enrolled patients, Dr.
The trial steering group also published an analysis evaluating the association of depression with cardiovascular mortality and morbidity, all-cause mortality and incident dementia. Main study findings A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults.
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