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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Whilst each additional GDS point at baseline also increased these risks, the study was not designed to evaluate this association.
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 ]. Br J Clin Pharmacol. The s saw publication of landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ]. The trial steering group also published an analysis evaluating the association of depression with cardiovascular mortality and morbidity, all-cause mortality and incident dementia.
The optimal target BP among very elderly patients has yet to be defined. This appeared to detect small differences between the two trial arms, in favour of treatment. 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.
Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. The number of subjects who smoked cigarettes 2. Usable articles Nephrology Cardiology Geriatrics. Subjects were then randomized to one of two treatment arms, the thiazide like diuretic, indapamide sustained release, 1.
Whilst jyvet statistically significant reduction in congestive cardiac failure was also observed unadjusted HR 0. 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.
Retrieved from ” http: However there was a non-significant rise in all cause mortality RHR 1. Effects of treatment on morbidity in hypertension. Support Center Support Center.
Antihypertensive drugs in very old people: Treating very elderly hypertensive patients is rewarding: Views Read View source View history.
The Hypertension in the Very Elderly Trial – latest data
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. 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 ].
In fact, serious adverse events SAEs were observed post-randomization in the placebo group. 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.
The role of blood pressure control in preventing complications of hypertension. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. Five-year findings of the Hypertension Detection and Follow-up Program: Whilst these results strengthen the case for early benefit arising from anti-hypertensive therapy in octogenarians, the selective exclusion criteria are questionable.
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. Some have interpreted HYVET as a negative study, since the P value for the primary outcome of stroke did not reach statistical significance.
HYVET – Wiki Journal Club
Yet the authors of the meta-analysis noted that a hyevt, randomized controlled trial demonstrating no benefit from anti-hypertensive therapy, in this stusy, would negate the apparent benefits seen across their meta-analysis [ 11 ]. 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; However, with the passage of time, a progressive effort has been made to expand the evidence base for treatment in older adults.
Hypertension — treated and untreated. After a 2-month placebo run-in phase, 3, patients were randomized to active treatment or placebo with stratification according to age and sex. Medical Research Council trial of treatment of hypertension in older adults: Allowing for all fractures, regardless of whether they were incident, validated fractures or not, resulted in an adjusted HR of 0.
Thus, the benefit of treatment above 85—90 years of age remains uncertain [ 1819 ].