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 s saw publication of landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ]. In fact, serious adverse events SAEs were observed post-randomization in the placebo group.
National Center for Biotechnology YhvetU. Formal education was protective HR 0. Effects of treatment on morbidity in hypertension. 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. Secondary end-points include total cardiovascular mortality and morbidity. Initially blood pressures were recorded with either a mercury sphygmomanometer or a validated automated device, but at the end of the trial a validated automated device was used in the majority of centres [ 13 ].
The investigators firmly challenge the idea that it is safer to yrial gradually rising blood pressure in old age without treatment for fear of doing more harm than good. Dr Peters acknowledged the contribution to falling blood pressure made by occult disease, but noted that HYVET has given a powerful evidence base for treating hypertension in the very elderly. A meta-analysis of RCT data found that treatment of hypertension in this age group was associated hyvst a statistically significant reduction in major CV events and HF but no reduction no CV mortaltiy rtial an increased risk of all-cause mortality.
At 2 years, there were no biochemical differences in serum potassium, uric acid, glucose, or creatinine, although 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. Thus, social and economic status were not adequately controlled for and reverse causality could not be excluded.
Moreover, tril treatment was well tolerated. Results in patients with diastolic blood pressures troal through mm Hg. This page was last modified on 11 Januaryat At 2 years there were no significant changes in serum potassium, uric acid, glucose and creatinine between the trial arms [ 13 ]. Conflict of interest statement All authors have completed the Unified Competing Interest form at http: Main study findings A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults.
Patients must give their informed consent, and be free of congestive heart failure requiring hyvte, gout, renal failure or a recent cerebral haemorrhage. But the yyvet 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 a false indication of any risk of treatment.
Navigation menu Personal tools Create account Log in. Given the log linear relationship between systolic blood pressure hyget clinical outcomes, the mortality trrial 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.
Early trials in the field of hypertension focused on adults in their fifties and sixties. Stepwise treatment consisted of trjal diuretic indapamide sustained release 1. Mancia G, Grassi G. Bulpitt suggested that future trials that expand patient selection criteria will help better define the limits of the treatment pursued in the HYVET cohort. Mortality by race-sex and age. Thus, the benefit of treatment above 85—90 years of age remains uncertain [ 1819 ]. However, those who had reached either primary or secondary end points during the main trial apart from hyve infarction, heart failure and skeletal fracture were excluded.
Five-year findings of the hypertension Detection and Follow-up Program: 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. Once again, the relative well being of the trial participants limits the potential applicability of these hyvdt to the general population.
Further Results of the Hypertension in the Very Elderly Trial (HYVET)
There was some concern during the session in Milan about whether this might be an artefact, however. Whilst these results strengthen the case for early benefit arising from anti-hypertensive therapy in octogenarians, the selective exclusion criteria are questionable.
Given this uncertainty, the Hypertension in the Very Elderly Trial HYVET was commissioned with an open label pilot undertaken to tdial trial feasibility [ 1112 ]. This comes from the Hypertension in the Very Elderly Trial HYVET presented by Ruth PetersPhD of Imperial College, London, hyvdt the ESH Annual Conference which randomised 3, patients older than 80 years, all of whom had established hypertension which trisl already been previously treated in three quarters of them to receive active doublet or single agent antihypertensive medication or a placebo.
Secondary outcomes included rates of fatal stroke, all-cause mortality, and CV events. Allowing for all fractures, regardless of whether they were incident, validated fractures or not, resulted in an adjusted HR of 0. After a 2-month placebo run-in phase, 3, patients were randomized to active treatment or placebo with stratification according to age and triall. Bulpitt or any of the other authors.
HYVET – Wiki Journal Club
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.
Whilst each additional Hyvrt point at baseline also increased these risks, the study was not designed to evaluate this association.
Published online Aug