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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The primary outcome was the rate of fatal or nonfatal stroke excluding TIA. All authors have completed the Unified Competing Interest form at http: 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 disregulate blood pressure control, hyveh that this might give a false indication of any risk of treatment.

The investigators also observed a non-significant reduction in the primary outcome measure, stroke, unadjusted hazard ratio HR 0.

HYVET – Wiki Journal Club

As a result, it remains unclear whether such benefits persist or diminish over a longer time course and although the inclusion criteria allowed htvet the enrolment of patients aged between 80 and years, most were 80 to 85 years old mean age; Mortality by race-sex and age. Secondary end-points include total cardiovascular mortality and morbidity. Those on antihypertensives at baseline had their medications stopped prior to placebo run-in.

Allowing for all fractures, regardless of whether they were incident, validated fractures or not, resulted in an adjusted HR of 0. Dr Peters presented data in Milan of the relationship between achieved blood pressures after nine months and the observed events including dementia, total mortality, non-fatal and fatal myocardial infarctions and strokes.

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 trisl BP control, particularly in ISH, as opposed to achieved systolic and diastolic blood pressure. These drugs have been chosen as inexpensive and appropriate representatives of their therapeutic classes. 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 ].


In fact, serious adverse events SAEs were observed post-randomization in the placebo group. 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.

Hypertension in the Very Elderly Trial (HYVET): protocol for the main trial.

Having recruited large numbers hyvdt patients from Eastern Europe and China, the authors were criticized for not appreciating the increased prevalence of cerebrovascular events in these populations, when compared with adults from Western Europe — a factor which may exaggerate the potential benefit arising from active therapy [ 14 ]. When the p value for trend with age was corrected for gender, there were still few significant differences from the overall population. Whilst these results strengthen the case for early benefit arising from anti-hypertensive therapy in octogenarians, the selective exclusion criteria are questionable.

With safety always an issue in the elderly, the combination therapy proved to be extremely safe: Trial participants receiving double-blind treatment at their final visit within the main study were deemed eligible for inclusion.

Based on the originally published data, at a median follow-up of 1. The pilot phase of the trial has been started with support from the British Heart Foundation. A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults.

Br J Clin Pharmacol. Sociodemographic and lifestyle risk factors for incident dementia and cognitive decline in the HYVET. 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.

Received Apr 30; Accepted Aug However, with the passage of time, a progressive effort has been made to expand the evidence base for treatment in older adults. Results in patients with diastolic blood pressures averaging through mm Hg.

Starting dosage for bendroflumethiazide and lisinopril is 2. However, while treatment conferred considerable benefits on enrolled patients, Dr. Once again, the relative well being of the trial participants limits the potential applicability of these data to the general population. Views Read View source View history. 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 ].


However there was a non-significant rise in all cause mortality RHR 1. Stepwise treatment consisted of a diuretic indapamide sustained release 1. Antihypertensive drugs in very old people: Centres which are interested in taking part should contact C.

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.

Navigation menu Personal tools Create account Log in. 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.

Hypertension — treated and untreated. At 2 years there were no significant changes in serum potassium, uric acid, glucose and creatinine between the trial arms [ 13 ]. Published online Aug Secondary outcomes included rates of fatal stroke, all-cause mortality, and CV events.

Hypertension in the Very Elderly Trial (HYVET): protocol for the main trial.

Earlier this year, results from a 1 year open label active treatment extension of HYVET were published. The number rtial subjects who smoked cigarettes 2. Please review our privacy policy. Five-year findings of the Hypertension Detection and Follow-up Program: This page was last modified on 11 Januaryat 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.

Among very elderly patients with hypertension, does active treatment with antihypertensives reduce the rate of fatal or nonfatal stroke when hyvte with placebo? Effects of treatment on morbidity in hypertension. Treatment of hypertension in the elderly.