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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In addition, it was notable that four centres closed in the first year due to data quality issues [ 13 ]. Medical Research Council trial of treatment of hypertension in older adults: 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. Immediate and etudy benefits of treating very elderly people with hypertension: There were also significant reductions in rates of other secondary outcomes including fatal stroke, HF, and CV events.
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 stud. Whilst these results strengthen the case for early benefit arising from anti-hypertensive therapy in octogenarians, the selective exclusion criteria are questionable.
Thus, social and economic status were not adequately controlled for and reverse causality could not be excluded.
However, with the passage of time, a progressive effort has been made to expand the evidence base for treatment in older adults. The initial inclusion criteria demanded both systolic and diastolic hypertension SDH mean systolic BP — mmHg; mean diastolic BP 90— mmHgoff stuudy, during a 2 month run in period.
More importantly, the early evidence of mortality benefit wtudy in a relatively short duration of follow-up median 1. 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.
Reduction in mortality of persons with high blood pressure, including mild hypertension. When analyzing the 90 incident, validated fractures 38 in the active group; 52 in the placebo group and adjusting for baseline risk factors, a HR of 0. Trial participants receiving double-blind treatment at their final visit within the main study were deemed eligible for inclusion.
JNC 8 hypertension guidelinesadapted . Treatment of hypertension in patients 80 years of age or older. Subjects were then randomized to one of two treatment arms, the thiazide like diuretic, indapamide sustained release, 1. Views Read View source View history.
Treating very elderly hypertensive patients is rewarding: 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.
Formal education was protective HR 0.
HYVET – Wiki Journal Club
Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. 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 ]. Allowing for all fractures, regardless of whether they were hyvst, validated fractures or not, resulted in an adjusted HR of 0.
Once again, the relative well being of the trial participants limits the potential applicability of these data to the general population. Hyvte authors have completed the Unified Competing Interest form at http: More recently, additional data from this cohort has been studg 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.
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. Some have interpreted HYVET as a negative study, since the P value for the primary yyvet of stroke did not reach statistical significance.
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 ISH and the variable methods for measuring blood pressure. Br J Clin Pharmacol. This page was last modified on 11 Januaryat Whilst each additional Hhyvet point at baseline also increased these risks, the study was not designed to evaluate this association. Abstract Early trials in the field of hypertension focused on adults in their fifties and sixties.
However using these data, hgvet dynamic model of cognition that allowed all outcomes cognitive worsening, stability, improvement or death to be categorized simultaneously was developed. Author information Article hyvwt Copyright and License information Disclaimer. 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 ].
Earlier this year, results from a 1 year open label active treatment extension of HYVET were published. At 2 years there were no significant changes in serum potassium, uric acid, glucose and creatinine between the trial arms [ 13 ].
Randomised double-blind hyveet of placebo and active treatment for older patients with isolated systolic hypertension.
[HYVET study – treatment for hypertension].
Beckett NS, et al. Moreover, active treatment was well tolerated. Again, differences were seen for all-cause mortality 47 deaths; HR 0.