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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When analyzing the 90 incident, validated fractures 38 in the active group; 52 in the placebo group and adjusting for hyveh risk factors, a HR of 0. 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: Five-year findings of the hypertension Detection and Follow-up Program: It is possible that the difference in stroke rates would have reached statistical significance had the trial not been stopped early.
A double-blind placebo-controlled trial with hyvdt centres in 13 countries, HYVET prospectively analyzed data from older adults. Abstract Early trials in the field of hypertension focused on adults in their fifties and sixties.
Thus, social and economic status were not adequately controlled for and reverse causality could not be excluded.
Stepwise treatment consisted of a diuretic indapamide sustained release 1. Introduction The s saw publication of landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ]. Main study findings A double-blind placebo-controlled trial with recruitment centres shudy 13 countries, HYVET prospectively analyzed data from older adults.
Medical Research Council trial of treatment of hypertension in older adults: The trial steering group also published an analysis evaluating the association of depression with cardiovascular mortality and morbidity, all-cause stury and incident dementia.
Formal education was protective HR 0. The New England Journal of Medicine. Influence of antihypertensive drug treatment on morbidity and mortality in etudy over the age of 60 years.
Beckett NS, et al. Association of depression with subsequent mortality, cardiovascular morbidity and incident dementia in people aged 80 and over and suffering from hypertension.
Some have interpreted HYVET as a negative study, since the P value for the primary outcome of stroke did not reach statistical significance. 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. The role of blood pressure control in preventing complications of hypertension.
N Engl J Med. 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 ].
[HYVET study – treatment for hypertension].
Initially blood pressures were recorded with hyvte a mercury sphygmomanometer or a validated automated device, but at the end of the trial a studg automated device was used in the majority of centres [ 13 ]. Support Center Support Center. Having recruited large numbers of 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 ].
The s saw publication of landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ]. The hyveet 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.
Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Moreover, active treatment was well tolerated.
After a 2-month placebo stuey phase, 3, patients were randomized to active treatment or placebo with stratification according to age and sex.
The Hypertension in the Very Elderly Trial – latest data
Again, differences were seen for all-cause mortality 47 deaths; HR 0. In that vein, some have expressed significant concerns with over-treatment of hypertension in the elderly, citing the risks of polypharmacy and the fact that elderly patients are prone to hypovolemia and orthostatic syncope, etc. 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.
Effects of treatment on morbidity in hypertension. In common with many other clinical trials in older people, the inclusion criteria also required that subjects be in relatively good physical and mental health individuals with dementia hyveg those resident in nursing homes were excludedquestioning the applicability of the trial outcomes to the real life setting [ 1316 ].
Yhvet for all fractures, regardless of whether they were incident, validated fractures or not, resulted in an adjusted HR of 0. Among very elderly patients with hypertension, does active treatment with antihypertensives reduce the rate of fatal or nonfatal stroke when compared with placebo? Treatment of hypertension in the elderly. However there was a non-significant rise in all cause mortality RHR 1.
The primary outcome was the rate of fatal or nonfatal stroke excluding TIA.
The Hypertension in the Very Elderly Trial – latest data
At 2 years there were no significant changes in serum potassium, uric acid, glucose and creatinine between the trial arms hyvdt 13 ]. Whilst these stidy strengthen the case for early benefit arising from anti-hypertensive therapy in octogenarians, the selective exclusion criteria are questionable.
Five-year findings of the Hypertension Detection and Follow-up Program: