hypertension in the very elderly trial (HYVET)

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hypertension in the very elderly trial (HYVET)

Study characteristics - 3845 healthy elderly >= 80 years of age, from Europe, China, Australasia, & Tunisia, mean age 83.6 years - funded by manufacturer of study drugs - mean blood pressure 173/91 mm Hg - study duration 2 years Groups: - treated with indapamide SA 1.5 mg or placebo + perindopril 2-4 mg or placebo as necessary to achieve BP of 150/80 Results: - BP lower in treatment group, mean = 15/6 mm Hg - 30% reduction in mortality from stroke in treated group (p=0.046), 12.4 vs 17.7 per 1000 patient years - number need to treat = 100 to prevent 1 stroke in 2 years - 21% reduction in all-cause mortality (p=0.02) - mortality 10% vs 12% - 64% reduction in heart failure - fewer adverse effects in the treatment group - another account states only 2 serious adverse events, both in the indapamide group - trial halted early because of ethical concerns * Editorialist notes that findings probably too good to be true. Risk of orthostatic hypotension & serious consequences (falls & fractures) likely to be much higher in practice.

blood pressure in the very old

General

hypertension clinical trials

References

Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L et al; the HYVET Study Group. Treatment of Hypertension in Patients 80 Years of Age or Older. N Engl J Med. 2008 Mar 31; [Epub ahead of print] PMID: 18378519 - Kostis JB Treating hypertension in the very old N Engl J Med 2008, March 31 PMID: 18378522

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