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Kidney function in the very elderly with hypertension: data from the hypertension in the very elderly (HYVET) trial.
MedLine Citation:
PMID:  22910302     Owner:  NLM     Status:  Publisher    
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Ruth Peters; Nigel Beckett; Ruth Poulter; Lisa Burch; Krzysztof Narkiewicz; Robert Fagard; Dorothea Nitsch; Nan Wang; Mengying Li; Astrid Fletcher; Christopher Bulpitt
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-21
Journal Detail:
Title:  Age and ageing     Volume:  -     ISSN:  1468-2834     ISO Abbreviation:  Age Ageing     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375655     Medline TA:  Age Ageing     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Imperial College London, London, UK.
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