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The aim of this trial is to investigate the effect of active. Drugs Aging. Earlier this year, results from a 1 year open label active treatment extension of HYVET were published. Hypertension — treated and untreated. Secondary outcomes included rates of fatal stroke, all-cause mortality, and CV events. These drugs have been chosen as inexpensive and appropriate representatives of their therapeutic classes. Early trials in the field of hypertension focused on adults in their fifties and sixties.
Five-year findings of the hypertension Detection and Follow-up Program: Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hyet. Bulpitt noted that nearly three-quarters of the patients in the active therapy group were receiving combination therapy, and the chemical effects of each drug likely mitigated those of the other agent.
The primary endpoint of HYVET was any fatal or nonfatal ttial, with secondary endpoints including all-cause mortality, cardiovascular mortality, cardiac death, and death from stroke. Association of depression with subsequent mortality, cardiovascular morbidity and incident dementia in people aged 80 and over and suffering from hypertension.
Results hyvt patients with diastolic blood pressures averaging through mm Hg. Antihypertensive drugs in very old people: The initial inclusion criteria demanded both systolic and diastolic hypertension SDH mean systolic BP — mmHg; mean diastolic BP 90— mmHgoff treatment, during a 2 month run in period.
The primary outcome was the rate of fatal or nonfatal stroke excluding TIA. Medical Research Council triial of treatment of hypertension in older adults: Abstract Early trials in the field of hypertension focused on adults in their fifties and sixties. He was anxious not to discourage teams from reducing pressures sufficiently, which he thought was generally very desirable for improving cardiovascular hyyvet rates in the very elderly.
Bulpitt noted, the number needed to treat was very low to prevent cardiovascular events: This comes from the Hypertension in the Very Elderly Trial HYVET presented by Ruth PetersPhD of Imperial College, London, at the ESH Annual Conference which randomised 3, patients older than 80 years, all of whom had established hypertension which had already been hjvet treated in three quarters of them to receive active doublet or single agent antihypertensive medication or a placebo.
Given the log linear relationship between systolic blood pressure hyvdt clinical outcomes, the mortality and morbidity benefits seen in the trial might be a feature of systolic BP control, particularly in ISH, as opposed to achieved systolic and diastolic blood pressure. Although the model requires further validation, it suggests that cognitive change in those aged over 80 years is small, depends on baseline cognitive function and the relative efficacy of anti-hypertensive treatment [ 25 ].
As a result, many benefits and risks of treating this population remain unclear. Furthermore, a failure to routinely identify vertebral fractures and difficulties in data collection may be sources of error. Patients are to be randomised to 3 groups- i no treatment; ii treatment with a diuretic [bendroflumethiazide bendrofluazide ]; or iii treatment with an angiotensin converting enzyme ACE inhibitor lisinopril.
Active therapy consisted of the diuretic indapamide 1. Additional non-protocol—specified antihypertensives were allowed for up to three months, after which patients were given the option of coming off study or entering open follow-up.
With safety always an issue in the elderly, the combination therapy proved to be extremely safe: Some have interpreted HYVET as a negative study, triql the P value for the primary outcome of stroke did not reach statistical significance. Five-year findings of the Hypertension Detection and Follow-up Program: What limited data are available have raised concerns. In that vein, some have expressed significant concerns with over-treatment of hypertension in the elderly, citing the risks of polypharmacy and the fact that elderly patients are prone to hypovolemia and orthostatic syncope, etc.
Active treatment was associated with a reduction in all teial and non-fatal cerebrovascular triwl with a relative hazard rate RHR of 0. Moreover, active treatment was well tolerated. Effects of treatment on morbidity in hypertension. As a result, it remains unclear whether such benefits persist or diminish over a longer time course and although the inclusion criteria allowed for the enrolment of patients aged between 80 and years, most were 80 to 85 years old mean age; Furthermore, standing and seated BPs post-treatment were equivalent, suggesting that antihypertensive therapy was not associated with orthostatic hypotension [ 13 ].
The aim trlal this trial is to investigate the effect of active treatment on stroke incidence in hypertensive patients over the age of 80 years. Whilst a trkal significant reduction in congestive cardiac failure was also observed unadjusted HR 0. Main study findings A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults. Hyget participants were 80 years or older and had persistent hypertension defined as systolic BP of at least mm Hg.
Again, differences were seen for all-cause mortality 47 deaths; HR 0. However there was a non-significant rise in all cause mortality RHR 1. A double-blind placebo-controlled trial with recruitment centres in 13 countries, HYVET prospectively analyzed data from older adults. The trial steering group also published an analysis evaluating the association of depression with cardiovascular mortality and morbidity, all-cause mortality and incident dementia.
The optimal target BP among very elderly patients has yet to be defined. The role of blood pressure control in preventing complications of hypertension. The number of subjects who smoked cigarettes 2.
Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. When analyzing the 90 incident, validated fractures 38 in the active group; 52 in the placebo group and adjusting for baseline risk factors, a HR of 0. Introduction The s saw publication of landmark data demonstrating the benefits of anti-hypertensive therapy [ 1 — 3 ]. It is possible that the difference in stroke rates would have reached statistical significance had the trial not been stopped early.
The study — the largest international, double-blind, placebo-controlled trial of its kind — concludes that very elderly patients with hypertension should be treated, and that this brings only benefits and not additional risks. Stepwise treatment consisted of a diuretic indapamide sustained release 1. Also required is a standing systolic blood pressure of at least mm Hg. Yet the authors of the meta-analysis noted that a single, randomized controlled trial demonstrating no benefit from anti-hypertensive therapy, in this cohort, would negate the apparent benefits seen across their meta-analysis [ trjal ].
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The aim of this trial is to investigate the effect of active. Drugs Aging. Earlier this year, results from a 1 year open label active treatment extension of HYVET were published. Hypertension — treated and untreated. Secondary outcomes included rates of fatal stroke, all-cause mortality, and CV events. These drugs have been chosen as inexpensive and appropriate representatives of their therapeutic classes.
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