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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There were also significant reductions in rates of other secondary outcomes including fatal stroke, HF, and CV events. The number of subjects who smoked cigarettes 2.
However there was a non-significant rise in all cause mortality RHR 1. The trial steering group also published an analysis evaluating the association of depression with cardiovascular mortality and morbidity, all-cause mortality and incident dementia.
[HYVET study – treatment for hypertension].
Antihypertensive drugs in very old people: Wtudy this year, results from a 1 year open label active treatment extension of HYVET were published. Author information Article notes Copyright and License information Disclaimer.
The New England Journal of Medicine.
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 ].
The investigators also observed a non-significant reduction in the primary outcome measure, stroke, unadjusted hazard ratio HR 0.
The Hypertension in the Very Elderly Trial – latest data
In addition, it was notable that four centres closed in the first year due to data quality issues [ 13 ]. 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.
Views Read View source View history. Furthermore, standing and seated BPs post-treatment were equivalent, suggesting that antihypertensive therapy was not associated with orthostatic hypotension [ 13 ].
Treatment of hypertension in the elderly. Secondary outcomes included rates of fatal stroke, all-cause mortality, and CV events. Thus, social and economic status were not adequately controlled for and reverse causality could not be excluded. Reduction in mortality of persons with high blood pressure, including mild hypertension.
The role of blood pressure control in preventing complications of hypertension. Among very elderly patients with hypertension, does active treatment with antihypertensives reduce the rate of fatal or nonfatal stroke when compared with placebo?
HYVET – Wiki Journal Club
N Engl J Med. Equally, at the time of the second interim analysis July the relative risk of all stroke fatal and non-fatal amongst those receiving active treatment was 0. Active treatment was associated with a reduction in all fatal and non-fatal cerebrovascular events with a relative hazard rate RHR of 0. Five-year findings of the hypertension Detection and Follow-up Program: Received Apr 30; Accepted Aug 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.
All authors have completed the Unified Competing Interest form at http: The primary outcome was the rate of fatal or nonfatal stroke excluding TIA. 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.
Allowing for all fractures, regardless of whether they were incident, validated fractures or not, resulted in an adjusted HR of 0. Treatment of hypertension in patients 80 years of age or older. Conflict of interest statement All authors have stuyd the Unified Competing Interest form at http: Results of the pilot study for the hypertension in studyy very elderly trial. 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.
However, at the time of the final intention-to-treat analysis in Nyvetthis significant reduction in the primary outcome measure failed to show statistical significance — the reasons for which have never been elaborated.
Retrieved from ” http: Whilst these results strengthen the case hvyet early benefit arising from anti-hypertensive therapy in octogenarians, the selective exclusion criteria are questionable. National Center for Biotechnology InformationU. Whilst a statistically significant reduction in congestive cardiac failure was also observed unadjusted HR 0.
[HYVET study – treatment for hypertension].
Once again, the relative well being of the trial participants limits the potential applicability of these data to the general population. Hvyet 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 ].
At 2 years there were no significant changes srudy serum potassium, uric acid, glucose and creatinine between the trial arms [ 13 ].
Moreover, active treatment was well tolerated. Br J Clin Pharmacol. Published online Aug Mortality by race-sex and age.