Navigation Links
Significant reductions in mortality shown using blood pressure-lowering treatment in very elderly
Date:3/31/2008

Lowering the blood pressure of elderly patients could cut their total mortality by a fifth and their rate of cardiovascular events by a third, according to a new study presented today (Monday 31 March) at the American College of Cardiology in Chicago and published simultaneously in the New England Journal of Medicine.

The 3,845 patient Hypertension in the Very Elderly Trial (HYVET), which is coordinated by scientists from Imperial College London, is the largest ever clinical trial to look at the effects of lowering blood pressure solely in those aged 80 and over. Patients were given either a placebo or the diuretic indapamide slow release (SR) 1.5mg, with the addition of the ACE inhibitor perindopril in tablet form once a day.

The research shows that the benefits of treatment include a 21% (p=0.02) reduction in total mortality rate, a 39% (p=0.05) reduction in stroke mortality rate, a 64% (p<0.001) reduction in fatal and non-fatal heart failures and a 34% (p<0.001) reduction in cardiovascular events. The benefits were apparent within the first year of follow-up.

The reduction in overall mortality was a novel and unexpected result. Earlier trials had demonstrated that reducing blood pressure in the under-80s reduces stroke and cardiovascular events. However, previous smaller and inconclusive studies also suggested that whilst lowering blood pressure in those aged 80 or over reduced the number of strokes, it did not reduce, and even possibly increased, total mortality.

In July 2007 the trial was stopped early on the recommendation of an independent data monitoring committee after they observed significant reductions in overall mortality and stroke in those receiving treatment. The final results of the trial showed a significant reduction in stroke mortality rate, but the reduction in all strokes of 30% did not quite reach statistical significance (p=0.06) In those aged 80 and over, up to half of strokes are fatal and the reduction in fatal strokes is an important finding.

Emeritus Professor Christopher Bulpitt, the lead investigator on the study from the Care of the Elderly Group at Imperial College London, said: "Before our study, doctors were unsure about whether very elderly people with high blood pressure could see the same benefits from treatment to lower their blood pressure as those we see in younger people. Our results clearly show that many patients aged 80 and over could benefit greatly from treatment. Populations are living longer and we have growing numbers of people living well into their 80s and beyond, so this is good news. We are very pleased that cardiovascular events were reduced safely with a reduction in total mortality."

The researchers hope that their findings will clear up uncertainty amongst clinicians about the benefits of treating those aged 80 and over for high blood pressure.

Dr Nigel Beckett, the trial co-ordinator from the Care of the Elderly Group at Imperial College London, added: "Many very elderly people with high blood pressure are not being treated for it at the moment, because doctors are unsure about whether or not treatment will help them. We hope that following our study, doctors will be encouraged to treat such patients in accordance with our protocol."

As the trial was stopped early, an extension involving patients receiving active-treatment is now underway to assess the longer term benefits of treatment.

Patients with high blood pressure (defined here as a systolic blood pressure between 160-199 mmHg), from thirteen countries across the world, were randomised for the double-blind, placebo-controlled trial, which began in 2001. The mean age of participants was 83 years and 7 months.

Patients were given either placebo or indapamide slow release (SR) with the addition of perindopril, in tablet form once a day as required, to achieve a target blood pressure of 150/80mmHg. The average follow-up of patients was just over 2 years by which time 20% of the placebo subjects and 48% of those taking medication had achieved the target blood pressure of 150/80 mmHg. In those patients who were followed up for longer, a larger number of patients receiving active treatment achieved the target blood pressure


'/>"/>

Contact: Laura Gallagher
L.Gallagher@imperial.ac.uk
44-078-038-86248
Imperial College London
Source:Eurekalert

Related medicine news :

1. MedCom Announces Card Activation Wins Significant Court Ruling
2. Significant Generic Erosion Will Cause Sales of Dyslipidemia Drugs to Decline by $3.6 Billion by 2016
3. Carnegie Mellon study shows just listening to cell phones significantly impairs drivers
4. NeurogesX to Present at Susquehanna Financial Groups 2nd Annual SIGnificant Options in Healthcare Conference
5. Novavax CEO to Present at Susquehannas Second SIGnificant Options in Healthcare Conference
6. Abaxis, Inc. to Present at the Susquehanna Financial Groups Second Annual SIGnificant Options in Healthcare Conference
7. Idenix Pharmaceuticals to Present at the SIGnificant Investment Options in Healthcare Conference
8. Advanced Life Sciences to Present at Susquehannas Second Annual SIGnificant Investment Options in Healthcare Conference
9. Significant Growth for Pinstripe Leads to Need for Larger Facility
10. Transcept Pharmaceuticals to Present at the Susquehanna Financial Groups SIGnificant Investment Options in Healthcare Conference
11. AAAS symposium to address significant effects of the male parent in reproductive success
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... June 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief ... a minimum wage raise to $12 an hour by 2020 and then adjusting it yearly ... lost value of the minimum wage, assure the wage floor does not erode again, and ...
(Date:6/24/2016)... Georgia (PRWEB) , ... June 24, 2016 , ... ... awards today at the Clinical Decision Making in Emergency Medicine conference in Ponte ... have authored journal articles published in Emergency Medicine Practice and Pediatric ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Investment Group (TGIG), has initiated cultivation and processing operations at its production facility, ... Pahrump, Nevada. , Puradigm is the manufacturer of a complete system of proactive ...
(Date:6/24/2016)... ... June 24, 2016 , ... National recruitment firm Slone Partners ... extensive sequencing and genomics experience, as Vice President of North American Capital Sales at ... responsible for leading the sales team in the commercialization of the HTG EdgeSeq system ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... human induced pluripotent stem (iPS) cells and other difficult to transfect cells, announces ... Medium. The PluriQ™ G9™ Gene Editing System is a complete system ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 2016   Pulmatrix, Inc ., (NASDAQ: ... drugs, announced today that it was added to the ... its comprehensive set of U.S. and global equity indexes ... important milestone for Pulmatrix," said Chief Executive Officer ... our progress in developing drugs for crucial unmet medical ...
(Date:6/23/2016)... -- Research and Markets has announced the addition ... 2022" report to their offering. ... with kidney failure, it replaces the function of kidneys by ... and thus the treatment helps to keep the patient body,s ... Increasing number of ESRD patients & substantial healthcare ...
(Date:6/23/2016)... , June 23, 2016 Roche (SIX: ... 510(k) clearance for its Elecsys BRAHMS PCT (procalcitonin) assay ... sepsis or septic shock. With this clearance, Roche is ... a fully integrated solution for sepsis risk assessment and ... with bacterial infection and PCT levels in blood can ...
Breaking Medicine Technology: