HYVETHypertension in the Very Elderly Trial
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* HYVET's cognitive function assessment did not find a significant reduction in the incidence of dementia with BP reduction over a short follow-up period, but when results were combined in a meta-analysis with other placebo-controlled, double-blind trials of antihypertensive treatments, there was significant reduction in incident dementia in patients randomized to antihypertensive treatment.
First, the mean age of patients in the HYVET treatment arm was 83.6 years old, with 73% of the patients being 80–84 years old.
Largely based upon the HYVET results, our most recent set of guidelines from April 2011 indicate that for patients older than 80 years, a reasonable target is a SBP of 140-145 mm Hg (no goal for DBP is provided).
Prior to the HYVET study, the treatment of hypertension in very elderly patients was not proven to be beneficial; the study showed unequivocally that initiation of treatment with indapamide, with or without perindopril vs.
With HYVET data, the average 10-year ASCVD risk would fall to 18.4%.
The Hypertension in the Very Elderly Trial (HYVET), which enrolled participants 80 years of age and older, demonstrated that reducing systolic BP (SBP) from 170 mm Hg to 145 mm Hg with indapamide sustained release 1.5 mg and perindopril 2 to 4 mg as needed reduced all-cause deaths 21% (P = .02), stroke-related deaths 39% (P = .05), and fatal and nonfatal heart failure (HF) 64% (P < .001), compared with placebo.
Beckett reported on behalf of the Hypertension in the Very Elderly Trial (HYVET) at the annual meeting of the American College of Cardiology.
Hypertension in the Very Elderly (HYVET), the most recent trial, randomized more than 3800 hypertensive patients over the age of 80 in Europe, China, Australia, and Tunisia to receive either a diuretic or placebo.
HYVET, a randomized, controlled trial of rational hypertension therapy in the very elderly, was presented at the recent scientific sessions of the American College of Cardiology.
However, results of the large Hypertension in the Very Elderly Trial (HYVET), published in the May 1, New England Journal of Medicine, may change this practice.