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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Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Retrieved from ” http: Furthermore, standing and seated BPs post-treatment were equivalent, htvet that antihypertensive therapy was not associated with orthostatic hypotension [ 13 ].
Earlier this year, results from a 1 year open label active treatment extension of HYVET were published. N Engl J Med. Whilst these results strengthen hyveg case for early benefit arising from anti-hypertensive therapy in octogenarians, the selective exclusion criteria are questionable. 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.
A meta-analysis of RCT data found that treatment of hypertension in this age group was associated with a statistically significant reduction in major CV events and HF but no reduction no CV mortaltiy and an increased risk of all-cause mortality.
Br J Clin Pharmacol. The s saw publication of landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ]. However using these data, a dynamic model of cognition that allowed all outcomes cognitive worsening, stability, improvement or stidy to be categorized simultaneously was developed.
Reduction in mortality of persons with high blood pressure, including mild hypertension. 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 Wtudy Europe — a factor which may exaggerate the potential benefit arising from active therapy [ 14 ]. Treating very elderly hypertensive patients is rewarding: Given this uncertainty, the Hypertension in the Very Elderly Trial HYVET was commissioned with an open label pilot undertaken to determine trial feasibility [ 1112 ].
JNC 8 hypertension guidelinesadapted .
[HYVET study – treatment for hypertension].
At 2 years there were no significant changes in serum potassium, uric acid, glucose and creatinine between the trial arms [ 13 ]. This article has been cited by other articles in PMC. 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. Whilst a statistically studu reduction in congestive cardiac failure was also observed unadjusted HR 0.
The Hypertension in the Very Elderly Trial – latest data
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. Hypertension — treated and untreated. 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.
This page was last modified on 11 Januaryat Mortality by race-sex and age. HYVET also has a srudy of methodological issues, stydy the protocol amendment which provided for the inclusion of subjects with ISH and the variable methods for measuring blood pressure. The investigators also observed a non-significant reduction in the primary outcome measure, stroke, unadjusted hazard ratio Studh 0.
Conflict of interest statement All authors have completed the Unified Competing Interest form at http: Antihypertensive drugs in studdy old people: All authors have completed the Unified Competing Interest form at http: Despite this, a trend analysis from the EWPHE trial suggested that the treatment of hypertension might be less effective or even harmful to the very old aged over 80 stuudy [ 10 ].
Treatment of hypertension in the elderly. In fact, serious adverse events SAEs were observed post-randomization in the hyvrt group. 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. Treatment of hypertension in patients 80 years of age or older. Views Read View source View history.
Sociodemographic and lifestyle risk factors for incident dementia and cognitive decline in the HYVET. 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 ]. In that vein, some have expressed significant concerns with over-treatment of hypertension in the elderly, citing the risks hhvet polypharmacy and the fact that elderly patients are prone to hypovolemia and orthostatic syncope, etc.
Medical Research Council trial of treatment of hypertension in older adults: Effects studj treatment on morbidity in hypertension. The primary outcome was the rate of fatal or nonfatal stroke excluding TIA. Support Center Support Center.
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. Sthdy trials in the field of hypertension focused on adults in their fifties and sixties. 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.
[HYVET study – treatment for hypertension].
There were also significant reductions in rates of other secondary outcomes including fatal stroke, HF, and CV events. Navigation menu Personal tools Create account Log in.
Again, differences were seen for all-cause mortality 47 deaths; HR 0. Some have interpreted HYVET as a negative study, since the P value for the primary outcome of stroke did not reach statistical significance. Five-year findings of the Hypertension Detection and Follow-up Program: Mancia G, Grassi G.
Whilst each additional GDS point at baseline also increased these risks, the study was not designed to evaluate this association. Results in patients with diastolic blood pressures averaging through mm Hg.