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:5/26/2016)... ... 26, 2016 , ... Intalere, the healthcare industry leader in ... inaugural Member Conference at the Paris Hotel in Las Vegas, Nev., May 17-20, ... America’s healthcare providers. , The conference was highlighted by the announcement of the ...
(Date:5/26/2016)... ... 26, 2016 , ... The Woodlands at John Knox Village , Florida’s ... care for living and healing, celebrated its grand opening, today. The Woodlands at John ... provided by Empowered Staff. , “This is an incredibly fulfilling time for John Knox ...
(Date:5/26/2016)... ... May 26, 2016 , ... ... development solutions for drugs, biologics, consumer health and global clinical supply services, today ... Korea to support the company’s continued investment and strategic growth plans in the ...
(Date:5/26/2016)... ... May 26, 2016 , ... Memorial Day Weekend marks the unofficial ... is sharing tips to make sure your family and vehicle are ready to ... Council, there may be 439 deaths and an additional 50,500 serious injuries from motor ...
(Date:5/26/2016)... ... 26, 2016 , ... North Cypress Medical Center hosted its 9th ... Cypress. With the help of community partners, the event organizers raised $45,000 for the ... wounded service members and their families through health, wellness, and therapeutic support. , ...
Breaking Medicine News(10 mins):
(Date:5/26/2016)... 2016 TARE (Transarterial Radio-embolization) ... Savings and Overall Decreased Use of Hospital ... international specialist healthcare company, has today announced the ... Meeting of ISPOR (International Society for Pharmacoeconomics and ... (HCC) using yttrium-90 glass microspheres is associated with ...
(Date:5/26/2016)... WELLESLEY, Massachusetts , May 26, 2016 ... sequencing (NGS) has matured into an essential life science ... research and development applications. BCC Research reveals in its ... of a second growth phase, one powered by a ... applied fields.      (Logo: http://photos.prnewswire.com/prnh/20140723/694805 ...
(Date:5/25/2016)... 25, 2016 According to a ... (3D, 2D, 4D), by Therapeutic Area (Oncology, Cosmeceutical/Plastic Surgery), ... (Medical Device Manufacturers, Hospitals/ Clinics) - Forecast to 2021", ... Animation Market for the forecast period of 2016 to ... Million by 2021 from USD 117.3 Million in 2016, ...
Breaking Medicine Technology: