Blood pressure control in the Hypertension in the Very Elderly Trial (HYVET).


Bulpitt, CJ; Beckett, NS; Peters, R; Leonetti, G; Gergova, V; Fagard, R; Burch, LA; Banya, W; Fletcher, AE; (2012) Blood pressure control in the Hypertension in the Very Elderly Trial (HYVET). Journal of human hypertension, 26 (3). pp. 157-63. ISSN 0950-9240 DOI: https://doi.org/10.1038/jhh.2011.10

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Abstract

: To report blood pressure control in the Hypertension in the Very Elderly Trial, a placebo-controlled trial of hypertensive (systolic blood pressure (SBP) 160-199?mm?Hg, diastolic blood pressure (DBP) <110?mm?Hg) participants over the age of 80 years, given treatment in three steps: indapamide slow release 1.5?mg alone, indapamide plus 2?mg perindopril and indapamide plus 4?mg perindopril. The difference in control between participants with combined systolic and diastolic hypertension (SDH, DBP?90?mm?Hg) and those with isolated systolic hypertension (ISH, DBP<90?mm?Hg) is determined together with the effects of increments in the treatment regimen. At 2 years, the active treatment lowered blood pressure by 16.5/6.9?mm?Hg more than that on placebo in participants with SDH and by 19.3/4.8?mm?Hg more in those with ISH. The 2-year falls in pressure on placebo alone were 13.2/8.5?mm?Hg in SDH and 8.2/1.5?mm?Hg in ISH participants. With full titration of active treatment, 62% of SDH participants achieved goal SBP (<150?mm?Hg) by 2 years and 71% of those with ISH. The corresponding results for DBP control (<80?mm?Hg) were 40 and 78%. The addition of active perindopril 2?mg roughly doubled the percentage controlled, as did increasing to 4 from 2?mg. Blood pressure control was good with ISH and better than with SDH. The fall in SBP accounted for the observed 30% reduction in strokes, but the 21% reduction in total mortality and 64% reduction in heart failure were greater than predicted.<br/>

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
PubMed ID: 21390056
Web of Science ID: 300324500003
URI: http://researchonline.lshtm.ac.uk/id/eprint/59

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