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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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 ].
Whilst a statistically significant reduction in congestive cardiac failure was also observed unadjusted HR 0. The investigators also observed a non-significant reduction in the primary outcome measure, stroke, unadjusted hazard ratio HR 0. This article has been cited by other articles in PMC. Treating very elderly hypertensive patients is rewarding: The number of subjects who smoked cigarettes 2.
Formal education was protective HR 0. Antihypertensive drugs in very old people: However, those who had reached either hgvet or secondary end points during the main trial apart from myocardial infarction, heart failure and skeletal fracture were excluded.
[HYVET study – treatment for hypertension].
Allowing for all fractures, regardless of whether they were incident, validated fractures or not, resulted in an adjusted HR of 0. Given the log linear relationship between systolic blood hhyvet 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. Abstract Early trials in the field of hypertension focused on adults in their fifties and sixties.
Again, differences were seen for all-cause mortality 47 deaths; HR 0.
The Hypertension in the Very Elderly Trial – latest data
HYVET also has a number of methodological issues, namely the protocol amendment which provided for the inclusion of subjects with Hyfet and the variable methods for measuring blood pressure.
However, with the passage of time, a progressive effort has been made to expand the evidence base for treatment in older adults. Thus, no significant difference was observed between the two trial arms HR 0. Those on antihypertensives at baseline had their medications stopped prior to placebo run-in.
Main study findings A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults. This appeared to detect small differences between the two trial arms, in favour of treatment.
Effects of treatment on morbidity in hypertension. Stepwise treatment consisted of a diuretic indapamide sustained release 1. Author information Article notes Copyright and License information Disclaimer.
Received Apr 30; Accepted Aug The initial inclusion criteria demanded both systolic and diastolic hypertension SDH mean hyvett BP — mmHg; mean diastolic BP 90— mmHgoff treatment, during a 2 month run in period. Whilst each additional GDS point at baseline also increased these risks, the study was not designed to evaluate this association.
After a 2-month placebo run-in phase, 3, patients were randomized to active treatment or stusy with stratification according to age and sex.
This hypothesis, that indapamide a thiazide-like diuretic reduces urinary calcium excretion and as a sudy may reduce fracture rates, was tested in a sub-study. Yet the authors wtudy the meta-analysis noted that a single, randomized controlled trial demonstrating no benefit from anti-hypertensive therapy, in this cohort, would negate the apparent benefits seen across their meta-analysis [ 11 ]. Treatment of hypertension in patients 80 years of age or older.
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.
The primary outcome was the rate of studyy or nonfatal stroke excluding TIA. This review provides an overview of the Hypertension in the Very Elderly Trial whilst also discursively evaluating the latest hjvet. The New England Journal of Medicine. This page was last modified on 11 Januaryat The optimal target BP among very elderly patients has yet to be defined. JNC 8 hypertension guidelinesadapted . Results of the pilot study for the hypertension in the very elderly trial.
Introduction The s saw publication of landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ]. It is possible that the difference in stroke rates would have reached statistical significance had the trial not been stopped early.
Sociodemographic and lifestyle risk factors for incident dementia and cognitive decline in the HYVET. Navigation menu Personal tools Create account Log in. Br J Clin Pharmacol.