(xxx)There will be a press briefing to discuss these findings
in Chicago on Monday, March 31 at 12:45 EDT.
Details of how to dial in and/or watch live streaming of the briefing
can be obtained from the ACC Press Office, (312) 949-3450(xxx)
MONTREAL, March 31 /CNW Telbec/ - 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 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 co-ordinated 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(less than)0.001) reduction in fatal and non-fatal
heart failures and a 34% (p(less than)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
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 150/80 mmHg. 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.
HYVET was co-ordinated by scientists from Imperial College London,
working with colleagues around the world. The main trial was funded by both
the British Heart Foundation and by Servier.
About Imperial College London
Imperial College London - rated the world's fifth best university in the
2007 Times Higher Education Supplement University Rankings - is a
science-based institution with a reputation for excellence in teaching and
research that attracts 12,000 students and 6,000 staff of the highest
international quality. Innovative research at the College explores the
interface between science, medicine, engineering and business, delivering
practical solutions that improve quality of life and the environment -
underpinned by a dynamic enterprise culture.
For further information:
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Laura Gallagher, Senior Press Officer, Imperial College London, Telephone: +44
(0)20 7594 6702 or ext. 46702, Out of hours Duty Press Officer: +44 (0)7803
886 248, L.Gallagher@imperial.ac.uk; www: www.imperial.ac.uk/press