Kidney function in the very elderly with hypertension: data from the hypertension in the very elderly (HYVET) trial
numerous reports have linked impaired kidney function to a higher risk of cardiovascular events and mortality. There are relatively few data relating to kidney function in the very elderly. the Hypertension in the Very Elderly Trial (HYVET) was a randomised placebo-controlled trial of indapamide slo...
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| Veröffentlicht in: | Age and ageing 2013-03, Vol.42 (2), p.253-258 |
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| creator | Peters, Ruth Beckett, Nigel Poulter, Ruth Burch, Lisa Narkiewicz, Krzysztof Fagard, Robert Nitsch, Dorothea Wang, Nan Li, Mengying Fletcher, Astrid Bulpitt, Christopher |
| description | numerous reports have linked impaired kidney function to a higher risk of cardiovascular events and mortality. There are relatively few data relating to kidney function in the very elderly.
the Hypertension in the Very Elderly Trial (HYVET) was a randomised placebo-controlled trial of indapamide slow release 1.5mg ± perindopril 2-4 mg in those aged ≥80 years with sitting systolic blood pressures of ≥160 mmHg and diastolic pressures of |
| doi_str_mv | 10.1093/ageing/afs109 |
| format | Article |
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the Hypertension in the Very Elderly Trial (HYVET) was a randomised placebo-controlled trial of indapamide slow release 1.5mg ± perindopril 2-4 mg in those aged ≥80 years with sitting systolic blood pressures of ≥160 mmHg and diastolic pressures of <110 mmHg. Kidney function was a secondary outcome.
HYVET recruited 3,845 participants. The mean baseline estimated glomerular filtration rate (eGFR) was 61.7 ml/min/1.73 m(2). When categories of the eGFR were examined, there was a possible U-shaped relationship between eGFR, total mortality, cardiovascular mortality and events. The nadir of the U was the eGFR category ≥60 and <75 ml/min/1.73 m(2). Using this as a comparator, the U shape was clearest for cardiovascular mortality with the eGFR <45 ml/min/1.73 m(2) and ≥75 ml/min/1.73 m(2) showing hazard ratios of 1.88 (95% CI: 1.2-2.96) and 1.36 (0.94-1.98) by comparison. Proteinuria at baseline was also associated with an increased risk of later heart failure events and mortality.
although these results should be interpreted with caution, it may be that in very elderly individuals with hypertension both low and high eGFR indicate increased risk.</description><identifier>ISSN: 0002-0729</identifier><identifier>EISSN: 1468-2834</identifier><identifier>DOI: 10.1093/ageing/afs109</identifier><identifier>PMID: 22910302</identifier><identifier>CODEN: AANGAH</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Age ; Age Factors ; Aged, 80 and over ; Aging ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Antihypertensive Agents - therapeutic use ; Blood pressure ; Blood Pressure - drug effects ; Clinical trials ; Complications and side effects ; Delayed-Action Preparations ; Demographic aspects ; Diuretics - therapeutic use ; Drug Therapy, Combination ; Elderly ; Elderly people ; Female ; Filtration ; Glomerular Filtration Rate ; Hazards ; Heart Failure - mortality ; Heart Failure - physiopathology ; Humans ; Hypertension ; Hypertension - drug therapy ; Hypertension - mortality ; Hypertension - physiopathology ; Indapamide - therapeutic use ; Kidney ; Kidney - physiopathology ; Kidney Diseases - mortality ; Kidney Diseases - physiopathology ; Kidney failure ; Kidney function tests ; Kidneys ; Male ; Mortality ; Older people ; Perindopril - therapeutic use ; Proportional Hazards Models ; Proteinuria - physiopathology ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome</subject><ispartof>Age and ageing, 2013-03, Vol.42 (2), p.253-258</ispartof><rights>Copyright Oxford Publishing Limited(England) Mar 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-cf0a0d883c412ec23eae459b2b5e79f54ccdbb0ed1c9d37e23cf9b75d040c1893</citedby><cites>FETCH-LOGICAL-c464t-cf0a0d883c412ec23eae459b2b5e79f54ccdbb0ed1c9d37e23cf9b75d040c1893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906,30980,30981</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22910302$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peters, Ruth</creatorcontrib><creatorcontrib>Beckett, Nigel</creatorcontrib><creatorcontrib>Poulter, Ruth</creatorcontrib><creatorcontrib>Burch, Lisa</creatorcontrib><creatorcontrib>Narkiewicz, Krzysztof</creatorcontrib><creatorcontrib>Fagard, Robert</creatorcontrib><creatorcontrib>Nitsch, Dorothea</creatorcontrib><creatorcontrib>Wang, Nan</creatorcontrib><creatorcontrib>Li, Mengying</creatorcontrib><creatorcontrib>Fletcher, Astrid</creatorcontrib><creatorcontrib>Bulpitt, Christopher</creatorcontrib><title>Kidney function in the very elderly with hypertension: data from the hypertension in the very elderly (HYVET) trial</title><title>Age and ageing</title><addtitle>Age Ageing</addtitle><description>numerous reports have linked impaired kidney function to a higher risk of cardiovascular events and mortality. There are relatively few data relating to kidney function in the very elderly.
the Hypertension in the Very Elderly Trial (HYVET) was a randomised placebo-controlled trial of indapamide slow release 1.5mg ± perindopril 2-4 mg in those aged ≥80 years with sitting systolic blood pressures of ≥160 mmHg and diastolic pressures of <110 mmHg. Kidney function was a secondary outcome.
HYVET recruited 3,845 participants. The mean baseline estimated glomerular filtration rate (eGFR) was 61.7 ml/min/1.73 m(2). When categories of the eGFR were examined, there was a possible U-shaped relationship between eGFR, total mortality, cardiovascular mortality and events. The nadir of the U was the eGFR category ≥60 and <75 ml/min/1.73 m(2). Using this as a comparator, the U shape was clearest for cardiovascular mortality with the eGFR <45 ml/min/1.73 m(2) and ≥75 ml/min/1.73 m(2) showing hazard ratios of 1.88 (95% CI: 1.2-2.96) and 1.36 (0.94-1.98) by comparison. Proteinuria at baseline was also associated with an increased risk of later heart failure events and mortality.
although these results should be interpreted with caution, it may be that in very elderly individuals with hypertension both low and high eGFR indicate increased risk.</description><subject>Age</subject><subject>Age Factors</subject><subject>Aged, 80 and over</subject><subject>Aging</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Blood pressure</subject><subject>Blood Pressure - drug effects</subject><subject>Clinical trials</subject><subject>Complications and side effects</subject><subject>Delayed-Action Preparations</subject><subject>Demographic aspects</subject><subject>Diuretics - therapeutic use</subject><subject>Drug Therapy, Combination</subject><subject>Elderly</subject><subject>Elderly people</subject><subject>Female</subject><subject>Filtration</subject><subject>Glomerular Filtration Rate</subject><subject>Hazards</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - mortality</subject><subject>Hypertension - physiopathology</subject><subject>Indapamide - therapeutic use</subject><subject>Kidney</subject><subject>Kidney - physiopathology</subject><subject>Kidney Diseases - mortality</subject><subject>Kidney Diseases - physiopathology</subject><subject>Kidney failure</subject><subject>Kidney function tests</subject><subject>Kidneys</subject><subject>Male</subject><subject>Mortality</subject><subject>Older people</subject><subject>Perindopril - therapeutic use</subject><subject>Proportional Hazards Models</subject><subject>Proteinuria - physiopathology</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0002-0729</issn><issn>1468-2834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqN0s1rFDEYBvAgFrtWj14l4KU9TJuvyUy8laW10kIvVfAUMsk7uynZzJpk1PnvnXWrFRH0FF7y4-FNeBB6RckpJYqfmRX4uDozfZ7HJ2hBhWwr1nLxFC0IIawiDVOH6HnO9_NIa8qeoUPGFCWcsAXK195FmHA_Rlv8ELGPuKwBf4E0YQgOUpjwV1_WeD1tIRWIeVZvsTPF4D4Nmx_697u_Jhxfffp4cXeCS_ImvEAHvQkZXj6cR-jD5cXd8qq6uX33fnl-U1khRalsTwxxbcutoAws42BA1KpjXQ2N6mthres6Ao5a5XgDjNtedU3tiCCWtoofoeN97jYNn0fIRW98thCCiTCMWVMuRSMll_V_UNpKJdtG_puyVolGCLqjb_6g98OY4vzmOZDxWqha7tas9mplAmgf7RALfCt2CAFWoOcvWd7qcy44Y7Sh_NHbNOScoNfb5DcmTZoSveuE3ndC7zsx-9cPW4zdBtwv_bME_DvrnbLf</recordid><startdate>201303</startdate><enddate>201303</enddate><creator>Peters, Ruth</creator><creator>Beckett, Nigel</creator><creator>Poulter, Ruth</creator><creator>Burch, Lisa</creator><creator>Narkiewicz, Krzysztof</creator><creator>Fagard, Robert</creator><creator>Nitsch, Dorothea</creator><creator>Wang, Nan</creator><creator>Li, Mengying</creator><creator>Fletcher, Astrid</creator><creator>Bulpitt, Christopher</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201303</creationdate><title>Kidney function in the very elderly with hypertension: data from the hypertension in the very elderly (HYVET) trial</title><author>Peters, Ruth ; Beckett, Nigel ; Poulter, Ruth ; Burch, Lisa ; Narkiewicz, Krzysztof ; Fagard, Robert ; Nitsch, Dorothea ; Wang, Nan ; Li, Mengying ; Fletcher, Astrid ; Bulpitt, Christopher</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-cf0a0d883c412ec23eae459b2b5e79f54ccdbb0ed1c9d37e23cf9b75d040c1893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age</topic><topic>Age Factors</topic><topic>Aged, 80 and over</topic><topic>Aging</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Blood pressure</topic><topic>Blood Pressure - drug effects</topic><topic>Clinical trials</topic><topic>Complications and side effects</topic><topic>Delayed-Action Preparations</topic><topic>Demographic aspects</topic><topic>Diuretics - therapeutic use</topic><topic>Drug Therapy, Combination</topic><topic>Elderly</topic><topic>Elderly people</topic><topic>Female</topic><topic>Filtration</topic><topic>Glomerular Filtration Rate</topic><topic>Hazards</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - mortality</topic><topic>Hypertension - physiopathology</topic><topic>Indapamide - therapeutic use</topic><topic>Kidney</topic><topic>Kidney - physiopathology</topic><topic>Kidney Diseases - mortality</topic><topic>Kidney Diseases - physiopathology</topic><topic>Kidney failure</topic><topic>Kidney function tests</topic><topic>Kidneys</topic><topic>Male</topic><topic>Mortality</topic><topic>Older people</topic><topic>Perindopril - therapeutic use</topic><topic>Proportional Hazards Models</topic><topic>Proteinuria - physiopathology</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peters, Ruth</creatorcontrib><creatorcontrib>Beckett, Nigel</creatorcontrib><creatorcontrib>Poulter, Ruth</creatorcontrib><creatorcontrib>Burch, Lisa</creatorcontrib><creatorcontrib>Narkiewicz, Krzysztof</creatorcontrib><creatorcontrib>Fagard, Robert</creatorcontrib><creatorcontrib>Nitsch, Dorothea</creatorcontrib><creatorcontrib>Wang, Nan</creatorcontrib><creatorcontrib>Li, Mengying</creatorcontrib><creatorcontrib>Fletcher, Astrid</creatorcontrib><creatorcontrib>Bulpitt, Christopher</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Age and ageing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peters, Ruth</au><au>Beckett, Nigel</au><au>Poulter, Ruth</au><au>Burch, Lisa</au><au>Narkiewicz, Krzysztof</au><au>Fagard, Robert</au><au>Nitsch, Dorothea</au><au>Wang, Nan</au><au>Li, Mengying</au><au>Fletcher, Astrid</au><au>Bulpitt, Christopher</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Kidney function in the very elderly with hypertension: data from the hypertension in the very elderly (HYVET) trial</atitle><jtitle>Age and ageing</jtitle><addtitle>Age Ageing</addtitle><date>2013-03</date><risdate>2013</risdate><volume>42</volume><issue>2</issue><spage>253</spage><epage>258</epage><pages>253-258</pages><issn>0002-0729</issn><eissn>1468-2834</eissn><coden>AANGAH</coden><abstract>numerous reports have linked impaired kidney function to a higher risk of cardiovascular events and mortality. There are relatively few data relating to kidney function in the very elderly.
the Hypertension in the Very Elderly Trial (HYVET) was a randomised placebo-controlled trial of indapamide slow release 1.5mg ± perindopril 2-4 mg in those aged ≥80 years with sitting systolic blood pressures of ≥160 mmHg and diastolic pressures of <110 mmHg. Kidney function was a secondary outcome.
HYVET recruited 3,845 participants. The mean baseline estimated glomerular filtration rate (eGFR) was 61.7 ml/min/1.73 m(2). When categories of the eGFR were examined, there was a possible U-shaped relationship between eGFR, total mortality, cardiovascular mortality and events. The nadir of the U was the eGFR category ≥60 and <75 ml/min/1.73 m(2). Using this as a comparator, the U shape was clearest for cardiovascular mortality with the eGFR <45 ml/min/1.73 m(2) and ≥75 ml/min/1.73 m(2) showing hazard ratios of 1.88 (95% CI: 1.2-2.96) and 1.36 (0.94-1.98) by comparison. Proteinuria at baseline was also associated with an increased risk of later heart failure events and mortality.
although these results should be interpreted with caution, it may be that in very elderly individuals with hypertension both low and high eGFR indicate increased risk.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>22910302</pmid><doi>10.1093/ageing/afs109</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Age and ageing, 2013-03, Vol.42 (2), p.253-258 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Applied Social Sciences Index & Abstracts (ASSIA); Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Age Age Factors Aged, 80 and over Aging Angiotensin-Converting Enzyme Inhibitors - therapeutic use Antihypertensive Agents - therapeutic use Blood pressure Blood Pressure - drug effects Clinical trials Complications and side effects Delayed-Action Preparations Demographic aspects Diuretics - therapeutic use Drug Therapy, Combination Elderly Elderly people Female Filtration Glomerular Filtration Rate Hazards Heart Failure - mortality Heart Failure - physiopathology Humans Hypertension Hypertension - drug therapy Hypertension - mortality Hypertension - physiopathology Indapamide - therapeutic use Kidney Kidney - physiopathology Kidney Diseases - mortality Kidney Diseases - physiopathology Kidney failure Kidney function tests Kidneys Male Mortality Older people Perindopril - therapeutic use Proportional Hazards Models Proteinuria - physiopathology Risk Assessment Risk Factors Time Factors Treatment Outcome |
| title | Kidney function in the very elderly with hypertension: data from the hypertension in the very elderly (HYVET) trial |
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