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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Stepwise treatment consisted of a diuretic indapamide sustained release 1.
Further Results of the Hypertension in the Very Elderly Trial (HYVET)
However, while treatment conferred considerable benefits on enrolled patients, Dr. 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.
Allowing for all fractures, regardless of whether they were incident, validated fractures or not, resulted in an adjusted HR of 0. 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.
However there was a non-significant rise in all cause mortality RHR 1. Also required is a standing systolic blood pressure of at least mm Hg.
The Hypertension in the Very Elderly Trial – latest data
Patients must give troal informed consent, and be free of congestive heart failure requiring treatment, gout, renal failure or a recent cerebral haemorrhage. Retrieved from ” http: Starting dosage for bendroflumethiazide and lisinopril is 2. Furthermore, a failure to routinely identify vertebral fractures and difficulties in data collection may be sources of error. 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.
Thus, no significant difference was observed between the two trial arms HR 0. The investigators also observed a non-significant reduction in the primary outcome measure, stroke, hyvdt hazard ratio HR 0. Influence of antihypertensive drug treatment on morbidity and mortality in patients over the age of 60 years.
Mancia G, Hyveh G. The s saw publication of landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ].
As a result, it remains unclear whether such benefits persist or diminish over a longer time course and although the hyvst criteria allowed for the enrolment of patients aged between 80 and years, most were 80 to 85 years triql mean age; 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.
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 hyvft to achieved systolic and diastolic blood pressure. 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.
Hypertension in the Very Elderly Trial (HYVET): protocol for the main trial.
The pilot phase of the trial has been started with support from the British Heart Gyvet. Mortality by race-sex and age. Out of the total population enrolled in HYVET, however, only 56 men and women were age 90 years or older.
Navigation menu Personal tools Create account Log in. However using these data, a dynamic model of cognition that allowed all outcomes cognitive worsening, stability, improvement or death to be categorized simultaneously was developed. Whilst these results strengthen the case for early benefit arising from anti-hypertensive therapy in octogenarians, the selective exclusion criteria are questionable.
This may reflect the relative physical well being of the trial population [ 24 ]. All participants were 80 years or older and had persistent hypertension defined as systolic BP of at least mm Hg. 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.
Secondary end-points include total cardiovascular mortality and morbidity. Yet the authors of 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 ]. More importantly, the early evidence of mortality benefit resulted in a relatively short duration of follow-up median 1.
This enhanced recruitment rates and led to the inclusion of subjects with isolated systolic hypertension ISH. As a result, many benefits and risks of treating this population remain unclear. In fact, serious adverse events SAEs were observed post-randomization in the placebo group.
Effects of treatment on morbidity in hypertension. Treatment of hypertension in the elderly. Those on antihypertensives at baseline had their medications stopped prior to placebo run-in. 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 ].
Formal education was protective HR 0. 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.
This page was last modified on 11 Januaryat Thus, the benefit of treatment above 85—90 years of age remains uncertain [ 1819 ]. All authors have completed the Unified Competing Interest form at http: