The mean age at baseline was About The incidence of prior stroke was 6. The study was terminated early, when the second planned interim analysis showed a significant reduction in the incidence of strokes, as well as total mortality in the indapamide arm.
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The mean age at baseline was About The incidence of prior stroke was 6. The study was terminated early, when the second planned interim analysis showed a significant reduction in the incidence of strokes, as well as total mortality in the indapamide arm. At the end of the trial, 1, patients were still undergoing double-blind follow-up. Over a median follow-up of 1. Similar results were obtained on the per-protocol analysis.
There was no significant difference between the two arms in the levels of potassium, uric acid, glucose, or creatinine. Serious side effects were more common in the placebo arm The number needed to treat at 2 years was 94 for stroke and 40 for mortality.
Interpretation: The results show that there is significant benefit obtained with the treatment of hypertension in patients older than 80 years with hypertension.
Treatment with indapamide reduces the incidence of strokes, mortality, and congestive heart failure in these patients. These benefits were noted early, with few significant side effects. This is a landmark study, which challenges current paradigms that question the risk—benefit of treating hypertension in patients older than 80 years of age.
Earlier epidemiologic studies had suggested that there was a potential for harm in patients over the age of 80 years who received antihypertensive treatment and had systolic blood pressure Newer guidelines will need to consider this population specifically, with defined blood pressure goals. Although indapamide is different compared with hydrochlorothiazide, they both have similar mechanisms of action, and so treatment with hydrochlorothiazide should be an effective initial treatment regimen in these patients.
Treatment of hypertension in patients 80 years of age or older. N Engl J Med ; Presented by Dr. Share via:.
Hypertension in the Very Elderly Trial - HYVET
A meta-analysis of RCT data found that treatment of hypertension in this age group was associated with a statistically significant reduction in major CV events and HF but no reduction no CV mortaltiy and an increased risk of all-cause mortality. After a 2-month placebo run-in phase, 3, patients were randomized to active treatment or placebo with stratification according to age and sex. Stepwise treatment consisted of a diuretic indapamide sustained release 1. 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. The primary outcome was the rate of fatal or nonfatal stroke excluding TIA. Secondary outcomes included rates of fatal stroke, all-cause mortality, and CV events.
The Hypertension in the Very Elderly Trial – latest data