results HYVET 2: treatment of white coat hypertension in the very elderly This study is looking at whether it is possible to run a trial to treat white coat. 17 Aug Given this uncertainty, the Hypertension in the Very Elderly Trial (HYVET) was commissioned with an open label pilot undertaken to determine. 31 Mar The study, called the Hypertension in the Very Elderly Trial (HYVET), was halted in August on the recommendation of the data and safety.
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Heart failure requiring treatment with drugs having an antihypertensive effect 8.
HYVET 2: treatment of white coat hypertension in the very elderly
However, research uyvet wider benefits to society and this study may help to improve care for others with a similar condition in the future. Notes Cite this as: Differential survival between those on active and placebo drugs and withdrawal rates in the main trial meant that the numbers in each hyvft who remained on double blind treatment at the end of the main trial were not balanced.
Immediate and late benefits of treating very elderly people with hypertension: Trial registration Clinical trials NCT These included all strokes fatal and non-fatal, but not transient ischaemic attackstotal mortality, cardiovascular mortality, cardiac mortality, and mortality from stroke.
Participants provided written informed consent before starting the extension. Differences were seen for total mortality 47 deaths; hazard ratio 0.
Characteristics of patients who entered one year extension at start of extension, compared with those who did not enter extension. Secondary outcomes included rates of fatal stroke, all-cause mortality, and CV events.
Further research is also needed into whether lowering systolic blood pressure to below mm Hg in people aged 80 or more is truly beneficial. Cossington House Surgery UK 3. At the end of the double blind phase and at the end of the one year extension, we collected information on current diseases, drug treatment, blood pressure, biochemistry sodium, potassium, urea, creatinine, glucose, uric acid cholesterol total and high density lipoproteinand haematology haemoglobin, haematocrit.
There were also significant reductions in rates of other secondary outcomes including fatal stroke, HF, and CV events. The participation rates were hjvet at HYVET 2 is a feasibility study which will focus on the following outcomes: Medscape App Get fast, accurate answers for point-of-care decision making.
Participants entering the extension had not reached a cardiovascular end point during the main trial, so the results of both studies are most applicable to preventing cardiovascular events in people free of established cardiovascular disease. View popup View inline. Cardiac mortality included fatal myocardial infarction, fatal heart failure, and sudden hvyet. Similarly, we found no differences between the two groups for heart failure events hazard ratio 0. The treatment regimen was as used in the main trial—indapamide SR 1.
Capacity to consent 6.
ISRCTN – ISRCTN HYVET 2: treatment of white coat hypertension in the very elderly
Get helpful advice on your cases from a community of physicians. The local investigators did not report any serious adverse drug reactions during the extension period. The benefit was achieved by lowering systolic blood pressure to mm Hg; any benefit of lowering blood pressure further cannot be assumed.
The fact that differences remained in all cause mortality and cardiovascular mortality supports the idea that some benefits tfial control of blood pressure take longer to accrue and that early treatment is thus warranted.
No additional information was collected on the participants hyvwt in each group who did not consent to enter the open label extension or the participants who were on open label treatment at the end of the main trial. It will entail a 1: Those on antihypertensives at baseline had their medications stopped prior to placebo run-in. Planned publication in a high-impact peer reviewed journal.
Article Related content Metrics Responses Peer review. Please contact the corresponding author. At the start of the trial inthe average seated diastolic blood pressure trkal to be mm Hg, but in a protocol amendment relaxed this criterion to less than mm Hg, allowing the inclusion of patients with isolated systolic hypertension; the standing systolic blood pressure criterion remained the same at mm Hg or above.
No significant changes in blood glucose occurred in the extension of HYVET, in keeping with the result during the main trial. We used the Kaplan-Meier method to estimate cumulative incidence curves. During the one year extension, visits took place every three months.
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No further follow-up data were collected on participants on open label drug at the time of the final main trial visits. People aged 80 or more with sustained systolic blood pressures of mm Hg or more benefit from blood pressure lowering treatment.
During the main trial, participants who reached the primary or secondary end points apart from myocardial infarction, heart failure, and skeletal fracture were withdrawn from double blind treatment; even if they were followed up on open label drug teial the event, they would not have been eligible for the extension.