Kidney function in the very elderly with hypertension: data from the hypertension in the very elderly (HYVET) trial.
Peters, Ruth;
Beckett, Nigel;
Poulter, Ruth;
Burch, Lisa;
Narkiewicz, Krzysztof;
Fagard, Robert;
Nitsch, Dorothea;
Wang, Nan;
Li, Mengying;
Fletcher, Astrid;
+1 more...Bulpitt, Christopher;
(2013)
Kidney function in the very elderly with hypertension: data from the hypertension in the very elderly (HYVET) trial.
Age and ageing, 42 (2).
pp. 253-258.
ISSN 0002-0729
DOI: https://doi.org/10.1093/ageing/afs109
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
BACKGROUND: numerous reports have linked impaired kidney function to a higher risk of cardiovascular events and mortality. There are relatively few data relating to kidney function in the very elderly. METHODS: the Hypertension in the Very Elderly Trial (HYVET) was a randomised placebo-controlled trial of indapamide slow release 1.5mg ± perindopril 2-4 mg in those aged ≥80 years with sitting systolic blood pressures of ≥160 mmHg and diastolic pressures of <110 mmHg. Kidney function was a secondary outcome. RESULTS: HYVET recruited 3,845 participants. The mean baseline estimated glomerular filtration rate (eGFR) was 61.7 ml/min/1.73 m(2). When categories of the eGFR were examined, there was a possible U-shaped relationship between eGFR, total mortality, cardiovascular mortality and events. The nadir of the U was the eGFR category ≥60 and <75 ml/min/1.73 m(2). Using this as a comparator, the U shape was clearest for cardiovascular mortality with the eGFR <45 ml/min/1.73 m(2) and ≥75 ml/min/1.73 m(2) showing hazard ratios of 1.88 (95% CI: 1.2-2.96) and 1.36 (0.94-1.98) by comparison. Proteinuria at baseline was also associated with an increased risk of later heart failure events and mortality. CONCLUSIONS: although these results should be interpreted with caution, it may be that in very elderly individuals with hypertension both low and high eGFR indicate increased risk.