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UMDNJ-Robert Wood Johnson Medical School Physician -- Editorial to appear in New England Journal of Medicine --
New Brunswick, NJ – In an editorial released today that will appear in the May 1 issue of the New England Journal of Medicine, John B. Kostis, MD, the John G. Detwiler Professor of Cardiology, professor of medicine and chair, department of medicine at UMDNJ-Robert Wood Johnson Medical School, and chief of medical service at Robert Wood Johnson University Hospital, advocates that it is never too late, or too early, to start drug treatment of hypertension. Dr. Kostis noted that the Hypertension in the Very Elderly Trial (HYVET), the results of which are being presented today at the American College of Cardiology Conference and which included persons aged 80 to 105 years old, “puts the question of usefulness of treating hypertension in the very old to rest and provides important guidance to physicians.” The 3,845 patient HYVET is the largest ever clinical trial to look at the effects of lowering blood pressure solely in those aged 80 and over. The international trial, which began in 2001, was stopped early because the researchers observed significant reductions in overall mortality in those receiving treatment. As noted in the editorial, the study is important because previous research had indicated that, although lowering blood pressure through drug therapy in persons over 80 reduced stroke and heart attack, there was a question on the effect of treatment on total mortality. Also, epidemiologic studies had suggested a higher mortality in very old persons with low blood pressure. According to Dr. Kostis, the results of HYVET prove that these fears were unfounded and that treatment of hypertension in the very old is beneficial. ”Although there is overwhelming evidence that favors antihypertensive drug therapy in younger age groups, HYVET focused specifically on very old persons who are often not included in clinical trials,” said Dr. Kostis. “This study proves the benefit of treating hypertension in people over 80 and provides clear direction for physicians and writers of management guidelines.” Also, Dr. Kostis, in his editorial, discusses young persons with hypertension (or high cholesterol) who may need drug therapy for 30 to 60 years. However, current practice is based on clinical trials usually lasting 5 years or less. Dr. Kostis is a nationally-recognized cardiologist. In addition to his positions at Robert Wood Johnson Medical School, where he developed a state-of-the-art tertiary cardiology program and established clinical research in cardiology, he also has served as chief of the coronary care unit, chief of the cardiac catheterization laboratory, chief of the non-invasive cardiac laboratory and chief of cardiology at Robert Wood Johnson University Hospital. Dr. Kostis’ research interests include clinical trials, cardiovascular pharmacology and biomedical engineering. He has developed the Myocardial Infarction Data Acquisition System (MIDAS), a statewide myocardial infarction database that has achieved international renown through its publications including one of the first reports of differentiation of women with acute myocardial infarction. He has served as principal investigator and had leadership roles in many national and international trials and in the field of biomedical engineering, he has worked on the development of noninvasive diagnostic techniques including one of the first applications of Doppler echocardiography in cardiology and is involved in two patents. To interview Dr. Kostis contact Jennifer Forbes at (732) 235-6356 or Patricia Hansen at (732) 235-6307
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