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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Five-year findings of the hypertension Detection and Follow-up Program: Furthermore, a failure to routinely identify vertebral fractures and difficulties in data collection may be sources of error.
Treating very elderly hypertensive patients is rewarding: Thus, no significant difference was observed between the two trial arms HR 0.
Five-year findings of the Hypertension Detection and Follow-up Program: Association of depression with subsequent mortality, cardiovascular morbidity and incident dementia in people aged 80 and over and suffering from hypertension.
This treatment regimen was also found to be associated with a large and significant reduction in heart failure, whilst proving particularly efficacious in the management of isolated systolic hypertension. Influence of antihypertensive drug treatment on morbidity and mortality in patients over the age of 60 years.
Hypertension In The Very Elderly Trial (HYVET): Lower Is Better, But Not Too Low
The optimal target BP among very elderly patients has yet to be defined. At 2 years there were no significant changes in serum potassium, uric acid, glucose and creatinine between the trial arms [ trila ].
Once again, the relative well being of the trial participants limits the potential applicability of these data to the general population. National Center for Biotechnology InformationU. 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. Triaal of interest statement All authors have completed the Unified Competing Interest form at http: Additional non-protocol—specified antihypertensives were allowed for up to three months, after which patients were given the option of coming off study or entering open follow-up.
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.
HYVET – Wiki Journal Club
He was anxious not to discourage teams from reducing pressures sufficiently, which he thought was generally very desirable for triwl cardiovascular mortality rates in the very elderly. After a 2-month placebo run-in phase, 3, patients were randomized to active treatment or placebo with stratification according to age and sex. The study — the largest international, double-blind, 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.
The trial steering group also published an analysis evaluating the association of depression with cardiovascular mortality and morbidity, all-cause mortality and incident dementia.
Bulpitt suggested that future trials that expand patient selection criteria will help better define the limits of the treatment pursued in the HYVET cohort. All participants were 80 years or older and had persistent hypertension defined as systolic BP of at least mm Hg.
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 to hyvte active doublet or single agent antihypertensive medication or a placebo. Trial participants receiving double-blind treatment at their final visit within the main study were deemed eligible for inclusion.
Some have interpreted HYVET yyvet a negative study, since the P value for the primary outcome of stroke did not reach statistical significance. Author information Article notes Copyright and License information Disclaimer.
It is possible that the difference in stroke rates would have reached statistical significance had the trial not been stopped early. As a result, it remains unclear whether such benefits persist or diminish over a longer time course and although the inclusion criteria allowed for the enrolment of patients aged between 80 and hhvet, most were 80 to 85 years old mean age; All authors have completed the Htvet Competing Interest form at http: More importantly, the early evidence of mortality benefit resulted in a relatively short duration of follow-up median 1.
Sociodemographic and lifestyle risk factors for incident dementia and cognitive decline in the HYVET. Treatment of hypertension in patients 80 years of age or older. Allowing for all fractures, regardless of whether they were incident, validated fractures or not, resulted jyvet an adjusted HR of 0.
Hypertension in the Very Elderly Trial (HYVET): protocol for the main trial.
Beckett NS, et al. However there was a non-significant rise in all cause mortality RHR 1. 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, and that this might give gyvet false indication of any risk of treatment.
Centres which are interested in taking part should contact C. Bulpitt or any of the other authors.
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.