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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HYVET – Wiki Journal Club
However, while treatment conferred considerable benefits on enrolled patients, Dr. The role of blood pressure control in preventing complications of hypertension.
Once again, the relative well being of the trial participants limits the potential applicability of these data to the general population. Patients must give their informed consent, and be free of congestive heart failure requiring treatment, gout, renal failure or a recent cerebral haemorrhage.
Beckett NS, et al. Furthermore, standing and seated BPs post-treatment were equivalent, suggesting that antihypertensive therapy was not associated with orthostatic hypotension [ 13 ]. Patients are to be randomised to 3 groups- i no treatment; ii treatment with a diuretic [bendroflumethiazide bendrofluazide ]; or iii treatment with an angiotensin converting enzyme ACE inhibitor lisinopril.
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. 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. Influence of antihypertensive drug treatment on morbidity and mortality in patients over the age of 60 years.
The primary outcome was the rate of fatal hyve nonfatal stroke excluding Hyvvet. Again, differences were seen for all-cause mortality 47 deaths; HR 0.
In addition, it was notable that four centres closed in the first year due to data quality issues [ 13 ]. He then considered whether these results could be generalized to individuals older than 90 years and those with previous cardiovascular disease. Main study findings A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults.
However, with the passage of time, a progressive effort has been made to expand the evidence base for treatment in older adults. 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. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension.
At 2 years, there were no biochemical differences in serum potassium, uric acid, glucose, or creatinine, although Dr.
Earlier this year, results from a 1 year open label active treatment extension of HYVET were published. Active therapy consisted of the diuretic indapamide 1. Treatment of hypertension in patients 80 years of age or older. With safety always an issue in the elderly, the combination therapy proved to be extremely safe: Additional non-protocol—specified antihypertensives nyvet allowed for up to three months, after which tril were given hyvett option of coming off study or entering open follow-up.
These drugs have been chosen as inexpensive and appropriate representatives of their therapeutic classes. Bulpitt noted that nearly three-quarters of the patients in the active therapy group were receiving combination therapy, and the chemical effects of each drug likely mitigated those of the other agent.
Moreover, active treatment was well tolerated.
The Hypertension in the Very Elderly Trial – latest data
Support Center Support Center. Association of depression with subsequent mortality, cardiovascular morbidity and incident dementia in people aged 80 and over and suffering from hypertension. Centres which are interested in taking part should contact C. Secondary outcomes included rates of fatal stroke, all-cause mortality, and CV events.
However, those who had reached either primary or secondary end points during the main trial apart from myocardial infarction, heart failure and skeletal fracture were excluded. When analyzing the 90 incident, validated fractures 38 in the active group; yyvet in the placebo group and adjusting for baseline risk factors, a HR of 0. Author information Article notes Copyright and License information Disclaimer.
What limited data are available have raised concerns. Starting dosage for bendroflumethiazide and lisinopril is 2. Hyevt using these data, a dynamic model of cognition that allowed all outcomes cognitive worsening, stability, improvement or death to be categorized simultaneously was developed.
Bulpitt noted, the number needed to treat was very low to prevent cardiovascular events: Active treatment was associated with a reduction in all fatal and non-fatal cerebrovascular events with a relative hazard rate RHR of 0. More importantly, the early evidence of mortality benefit resulted in a relatively short duration of follow-up median 1. Dr Peters presented data in Milan of hrial relationship between achieved blood pressures after nine months and the observed events including dementia, total mortality, non-fatal and fatal myocardial infarctions and strokes.
Immediate and late benefits of treating very elderly people with hypertension: This may reflect the relative physical well being of the trial population [ jyvet ]. The s saw publication tiral landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ].
Usable articles Nephrology Cardiology Geriatrics. JNC 8 hypertension guidelinesadapted .
Further Results of the Hypertension in the Very Elderly Trial (HYVET)
Medical Research Yhvet trial of treatment of hypertension in older adults: But the co-Chair of the session, Dr Jan Staesson from Leuven Belgium warned that among patients with dementia there could be some whose reduced blood pressure was partly caused by brain lesions which tril blood pressure control, and that this trual give a false indication of any risk of treatment. The initial inclusion criteria demanded both systolic and diastolic hypertension SDH mean systolic BP — mmHg; mean diastolic BP 90— mmHgoff treatment, during a 2 month run in period.
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 ].
Given the log linear relationship between systolic blood pressure and clinical outcomes, the mortality and morbidity benefits seen in the trial hhvet be a feature of systolic BP control, particularly in ISH, as opposed to achieved systolic and diastolic blood pressure. Whilst these results strengthen the case for early benefit arising from anti-hypertensive therapy in octogenarians, the selective exclusion criteria are questionable.