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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This article has been cited by other articles in PMC. This may reflect the relative physical well being of the trial population [ 24 ]. Starting dosage for bendroflumethiazide and lisinopril is 2. 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.
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 [ hvyet ].
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 trlal extension of the main study confirmed many of the original trial findings.
Bulpitt suggested that future trials that expand patient selection criteria will help better define the limits of the treatment pursued in the HYVET cohort. He was anxious not to discourage teams from reducing pressures hvyet, which he thought was generally very desirable for improving cardiovascular mortality rates in the very elderly.
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. Those on antihypertensives at baseline had their medications stopped prior to placebo run-in.
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 ].
At 2 years there were no significant changes in serum potassium, uric hyget, glucose and creatinine between the trial arms [ 13 ]. Results of the pilot study for the hypertension in the very elderly trial.
He then considered whether these results could be generalized to individuals older than 90 years and those with previous cardiovascular disease. This appeared to detect small differences between the two trial arms, in favour of treatment. However, at the time of the final intention-to-treat analysis in Octoberthis significant reduction in the primary outcome measure failed to show statistical significance — the reasons for which have never been elaborated.
In addition, it was notable trisl four centres closed in the first year due hvet data hyvwt issues [ 13 ]. Thus, social and economic status were not adequately controlled for and reverse causality could not be excluded. The optimal target BP among very elderly patients has yet to be defined.
Formal education was protective HR 0.
Hypertension In The Very Elderly Trial (HYVET): Lower Is Better, But Not Too Low
With safety always an issue in the elderly, the combination therapy proved to be extremely safe: The investigators firmly challenge the idea that it is safer to leave gradually rising blood pressure in old age without treatment for fear of doing more harm than good. The s saw publication of landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ]. A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults.
When the p value for trend with age was corrected for gender, there were still few significant differences from the overall population. Thus, no significant difference was observed between the two trial arms HR 0. However there was a non-significant rise in all cause mortality RHR 1.
The Hypertension in the Very Elderly Trial – latest data
This page trual last modified on 11 Januaryat Navigation menu Personal tools Create account Log in. N Engl J Med. Antihypertensive drugs in very old people: Active treatment was associated with a reduction in all fatal and non-fatal cerebrovascular events with a relative hazard rate RHR of 0. Treatment of hypertension in the elderly. Treating very elderly hypertensive patients is rewarding: Despite this, a trend analysis from the EWPHE trial suggested that the treatment of hypertension might be less effective or hgvet harmful to the very old aged over 80 years [ 10 ].
Thus, the benefit of treatment above 85—90 years of age remains uncertain [ 1819 ]. Views Read View source View history. Tgial authors have completed the Unified Competing Interest form at http: Five-year findings of the hypertension Detection and Follow-up Program: Secondary end-points include total cardiovascular mortality and morbidity. The aim of this trial is to investigate the effect of active treatment on stroke incidence in hypertensive patients over the age of 80 years.