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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Treatment of hypertension in patients 80 years of age or older.
Secondary outcomes included rates of fatal studg, all-cause mortality, and CV events. Published online Aug In fact, serious adverse events SAEs were observed post-randomization in the placebo group. 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.
However there was a non-significant rise in all cause mortality RHR 1. Abstract Early trials in the field of hypertension focused on adults in their fifties and sixties.
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, with the passage of time, a progressive effort has been made to expand the evidence base for treatment in older adults. 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 ]. More importantly, the early evidence of mortality benefit resulted in a relatively short duration of follow-up median 1.
Allowing for all fractures, regardless of whether they were incident, validated fractures or not, resulted in an adjusted HR of 0. At 2 years there were no significant changes in serum potassium, uric acid, glucose and creatinine between the trial arms [ 13 ].
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. Br J Clin Pharmacol.
Sociodemographic and lifestyle risk factors for incident dementia and cognitive decline in the HYVET. Five-year findings of the Hypertension Detection and Follow-up Program: Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. This enhanced recruitment rates and led to the inclusion of subjects with isolated systolic hypertension ISH.
Given this uncertainty, the Hypertension in the Very Elderly Trial HYVET was commissioned with an open label pilot undertaken to determine trial feasibility [ 1112 ]. Reduction in mortality of persons with high blood pressure, including mild hypertension.
Early trials in the field of hypertension focused on adults in their fifties and sixties. JNC 8 hypertension guidelinesadapted . Retrieved from ” http: Moreover, active treatment was well tolerated. This appeared to detect small differences between the two trial arms, in favour of treatment.
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 using these data, a dynamic model of cognition that allowed all outcomes cognitive worsening, stability, improvement or death to be categorized simultaneously was developed.
Again, differences were seen for all-cause mortality 47 deaths; HR 0. The number of subjects who smoked cigarettes 2. Treatment of hypertension in the elderly.
Treating very elderly hypertensive patients is rewarding: This review provides an overview of the Hypertension in the Very Elderly Trial whilst also discursively evaluating the latest data.
Yet the authors of the meta-analysis noted that a single, randomized controlled trial demonstrating no sfudy from anti-hypertensive therapy, in this cohort, would negate the apparent benefits seen across their meta-analysis [ 11 ]. When hyvef 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.
Beckett NS, et al. Results of the pilot study for the hypertension in the very elderly trial.
Results in patients with diastolic blood pressures averaging through mm Hg. 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 years [ 10 ].
Five-year findings of the hypertension Detection and Follow-up Program: National Center for Biotechnology InformationU. Among very elderly patients with hypertension, does active treatment with antihypertensives reduce the rate of fatal or nonfatal stroke when compared with placebo?
This article has been cited by other articles in PMC. The primary hycet was the rate of fatal or nonfatal stroke excluding TIA. Furthermore, standing and seated BPs post-treatment were equivalent, suggesting that antihypertensive therapy was not associated with orthostatic hypotension [ 13 ]. This may reflect the relative physical well being of the trial population [ 24 ].