Stroke :: Trial stops after stroke and mortality significantly reduced by blood pressure drugs

An international trial looking at the benefits of giving blood-pressure lowering medication to elderly patients has stopped early, after researchers observed significant reductions in overall mortality in those receiving treatment.

The 3,845 patient Hypertension in the Very Elderly Trial (HYVET) is thelargest ever clinical trial to look at the effects of lowering blood pressure solely in those aged 80 and over. Preliminary results of thetrial, which is coordinated by scientists from Imperial College London,suggest that lowering blood pressure significantly reduces both strokeand mortality in the over-80s.

A number of earlier trials had demonstrated that reducing blood pressurein the under-80s reduces stroke and cardiovascular events. However,previous smaller and inconclusive studies also suggested that whilstlowering blood pressure in those aged 80 or over reduced the number ofstrokes, it did not reduce, and even increased, total mortality.

Patients with high blood pressure from across the world were randomisedfor the double-blind, placebo-controlled trial, which began in 2001.Patients were given either the placebo or a low dose diuretic(indapamide 1.5mg SR), and an additional ACE inhibitor (perindopril), intablet form once a day.

Emeritus Professor Chris Bulpitt, HYVET Principal Investigator from theCare of the Elderly Department at Imperial College London, said: “It wasnot clear prior to our study whether the over-80s would benefit fromblood pressure lowering medication in the same way as younger people.Our results are great news for people in this age group because theysuggest that where they have high blood pressure, such treatment can cuttheir chances of dying as well as stroke.”

The Steering Committee of HYVET accepted on 12th July 2007 therecommendation of its Data Safety Monitoring Board that the trial shouldbe stopped.

Definitive figures will not be available until all the data has beencollected. Results will then be published in the peer reviewedscientific press.

Over the next few months all HYVET patients will be seen for a finalvisit, where all patients on trial medication will be offered the optionof switching to active indapamide 1.5 mg SR based antihypertensivetreatment. Prior to their final visit, all patients are advised to stayon their existing drugs until they see their trial physician.

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