HYVET trial: lowering blood pressure reduces mortality among those over 80

In the Hypertension in the Very Elderly Trial (HYVET)1, patients were either on indapamide slow release (SR) 1.5mg or placebo with the option to add perindopril 2-4mg once daily. The mean age of the 3,845 participants was 83 years and 7 months.

HYVET is the largest ever clinical trial to look at the effects of lowering blood pressure solely in those aged 80 and over. Previous smaller studies showed 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.

Patients on the indapamide SR 1,5mg-based therapy benefited in terms of 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.

According to Professor James Ker, Vice-dean of the Faculty of Health Sciences of the University of Pretoria, “The implications of this trial are clear: treat the elderly with hypertension, there are significant benefits.”

The over 80s is the fastest growing population group worldwide and considering that cerebrovascular disease is the leading cause of death in South Africa in the age group 65 years and older2, the rewards of lowering blood pressure in the very elderly certainly are numerous.

HYVET was initiated and co-ordinated by scientists from Imperial College London. The main trial was funded by both the British Heart Foundation and by Servier Laboratories.

For more information please visit www.HYVET.com

References:
1.Treatment of Hypertension in patients 80 years of age or older. HYVET study group. Beckett NS, et al. NEJM 2008; 358. DOI 10.1056/NEJMoa0801369
2.Statistics South Africa. 2005. Mortality and causes of death in South Africa 2005. Statistical release report P0309.3