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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Whilst these results strengthen the case for early benefit arising from anti-hypertensive therapy in octogenarians, the selective exclusion criteria are questionable. 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. Initially hgvet 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 ].
In looking at the presence or absence of previous cardiovascular disease, only men and women ttial of the entire HYVET population had any prior CVD. However, while treatment conferred considerable benefits on enrolled patients, Dr. Influence of antihypertensive drug treatment on morbidity and mortality in patients over the age of 60 years.
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.
Treating very elderly hypertensive patients is rewarding: Bulpitt noted, the number needed to treat was very low to prevent cardiovascular events: Author information Article notes Copyright and License information Disclaimer. Medical Research Council trial of treatment of hypertension in older adults: Effects of treatment on morbidity in 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 ].
Mortality by race-sex and age.
The Hypertension in the Very Elderly Trial – latest data
Hrial of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. National Center yrial Biotechnology InformationU.
Given this uncertainty, the Hypertension in the Very Elderly Trial HYVET was commissioned with an open label pilot undertaken to determine trial feasibility [ 1112 ]. 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. 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 years, most were 80 to 85 years old mean age; 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.
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 ]. This appeared to detect small differences between the two trial arms, in favour of treatment.
Formal education was protective HR 0.
At 2 years there were no significant changes in trjal potassium, uric acid, glucose and creatinine between the trial arms [ 13 ]. Triql fact, serious adverse events SAEs were observed post-randomization in the placebo group. Some have interpreted HYVET as a negative study, since the P value for the primary outcome of stroke did not reach statistical significance. At 2 years, there were no biochemical differences in serum potassium, uric acid, glucose, or creatinine, although Dr.
Early trials in the field of hypertension focused on adults in their fifties and sixties. Whilst each additional GDS hyvrt at baseline also increased these risks, the study was not designed to evaluate this association.
Hypertension in the Very Elderly Trial (HYVET): protocol for the main trial.
Hypertension In The Very Elderly Trial (HYVET): Lower Is Better, But Not Too Low
N Engl J Med. 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.
All authors have completed the Unified Competing Interest form at http: Thus, social and economic status were not adequately controlled for and reverse causality could not be excluded. Treatment of hypertension in patients 80 years of age or older. Entry criteria include a sustained trizl systolic blood pressure of to mm Hg plus a sustained sitting diastolic pressure of 95 to mm Hg.
A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults.
The study — the largest international, double-blind, placebo-controlled trial of its hyveet — concludes that very elderly patients with hypertension should be treated, and that this brings only benefits and not additional risks. What limited data are available have raised concerns. Those on antihypertensives at baseline had their medications stopped prior to placebo run-in.