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Efficacy and Safety of Valsartan and Nebivolol/Valsartan in Hypertensive Patients With LVH (BVreduce)

Primary Purpose

Hypertension Complicated, Hypertrophy, Left Ventricular, Blood Pressure

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Valsartan 80 mg
Sponsored by
Trinity Hypertension & Metabolic Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Hypertension Complicated

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Capable of reading, comprehending the consent process and providing written informed consent to participate in the study.
  2. Male or female ≥ 18 years of age who are either newly diagnosed with HTN or who are currently being treated.
  3. Patients must have a mean cuff sitting diastolic blood pressure cuff (DBP) > 90 mmHg and <105 mmHg (< 100 mmHg on prior treatment) and mean cuff sitting systolic blood pressure (SBP) <160 mmHg, at two consecutive qualifying visits during the placebo run in period.
  4. Arm circumference < 45cm.
  5. Compliance with single blind placebo capsules between V1 to 4 or 4X of 80-120%.
  6. Women may be enrolled if the following criteria are met:

1.- Have a negative serum pregnancy test at screening 2.- Are not breastfeeding 3.- Do not plan to become pregnant during the study 4.- Have had a hysterectomy or tubal ligation at least 6 months prior to signing the informed consent form or 5.- Have been postmenopausal for at least 1 year or 6. - If they are of childbearing potential and will practice one of the following methods of birth control throughout the study: oral, patch, injectable, or implantable hormone contraception, intrauterine device, diaphragm plus spermicide or female condom plus spermicide. Abstinence, partner's vasectomy are not acceptable methods of contraception.

7. Diagnosis of Left Ventricular Hypertrophy (LVH).

Exclusion Criteria:

  1. Known allergy or hypersensitivity to Beta-Blockers.
  2. Known allergy or hypersensitivity to Angiotensin II Receptor Blockers.
  3. Patients with severe hypertension (mean seated cuff DBP>115 mmHg or mean seated SBP> 180mmHg) or any form of secondary hypertension.
  4. Patients within the past 6 months with a history of hypertensive encephalopathy, stroke or transient ischemic attack.
  5. Patients within the last 6 months with a history of myocardial infarction, percutaneous transluminal coronary revascularization, coronary bypass graft, valvular surgery or unstable angina.
  6. Patients with evidence of resting bradycardia (<50 bpm) via palpation.
  7. Patients with a history of heart block greater than First Degree Sino-atrial Block. Wolff-Parkinson-White Syndrome, Sick Sinus Syndrome, Atrial Fibrillation, Atrial Flutter, Congestive Heart Failure, or other manifestations of clinically significant cardiac valvular disease.
  8. Patients with hemodynamically significant cardiac valvular disease.
  9. Patients with evidence of significant chronic renal impairment as indicated by a serum creatinine of > 2.5mg/dL.
  10. Patients with evidence of liver disease as indicated by AST (SGOT) or ALT (SGPT) > 2.5 times or total bilirubin > 1.5 times, the upper limit of the laboratory normal range.
  11. Patients who demonstrate other laboratory test values deviating from the normal range which are considered to be clinically significant by the investigator.
  12. Patient with a history or presence of gastrointestinal disease which may interfere with drug absorption.
  13. Patients with insulin and non-insulin dependent diabetes mellitus not controlled on diet, insulin, or oral hypoglycemics as defined by a HgA1c >10.
  14. Severe psychological or emotional condition which may interfere with participation in the study.
  15. History of or current use of illicit drugs or alcohol abuse.
  16. Participation in a clinical trial and taking any investigational drug within 30 days prior to enrolling into the study (Screening Visit).
  17. A physical condition that would limit accurate BP measurement.
  18. Inability to swallow a tablet or capsule.
  19. History of moderate or severe asthma or COPD.
  20. Any other medical condition which, in the Investigator's opinion, may render the patient unable to complete the study or which would interfere with optimal participation in the study or produce significant risk to the patient.
  21. Patients taking more than two blood pressure medications
  22. Patients currently taking a beta blocker

    -

Sites / Locations

  • Trinity Hypertension & Metabolic Research Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Valsartan Arm

Nebivolol/Valsartan

Arm Description

Valsartan 80mg randomly assigned for 8 weeks to asses BP control with office and 24-hour ABPM and reduction of LVH

Nebivolol/Valsartan 5/80mg randomly assigned for 8 weeks to asses Blood Pressure control with office and 24-hour Ambulatory Blood Pressure Monitoring and reduction of Left Ventricular Hypertrophy

Outcomes

Primary Outcome Measures

LVH reduction at 4 weeks.
Reduction of Left ventricular hypertrophy from baseline compared to 4 weeks of treatment
24hr-ABPM measurement Change from baseline in mean 24 hour ABPM SBP
Reduction of Systolic BP over 24 hours baseline compared to 4 weeks of treatment

Secondary Outcome Measures

LVH reduction at 8 weeks.
Reduction of Left ventricular hypertrophy from baseline compared to 8 weeks of treatment
24hr-Systolic ABPM measurement
Reduction of Systolic BP over 24 hours baseline compared to 8 weeks of treatment
24hr- DBP ABPM measurements
Mean change from baseline in trough DBP after 4 and 8 weeks of treatment with valsartan 80mg or nebivolol/valsartan 5/80mg
Office Blood Pressure measurements
Mean change from baseline in trough SBP after 4 and 8 weeks of treatment with valsartan 80mg or nebivolol/valsartan 5/80mg

Full Information

First Posted
June 6, 2017
Last Updated
April 10, 2018
Sponsor
Trinity Hypertension & Metabolic Research Institute
Collaborators
Allergan Sales, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03180593
Brief Title
Efficacy and Safety of Valsartan and Nebivolol/Valsartan in Hypertensive Patients With LVH
Acronym
BVreduce
Official Title
A Prospective, Randomized, Open-Label, 13 to 14-week Study of the Efficacy and Safety of Valsartan and Nebivolol/Valsartan in Hypertensive Subjects With Left Ventricular Hypertrophy (LVH)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
February 7, 2017 (Actual)
Primary Completion Date
January 25, 2018 (Actual)
Study Completion Date
January 25, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Trinity Hypertension & Metabolic Research Institute
Collaborators
Allergan Sales, LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
To assess the efficacy of Left Ventricular Hypertrophy (LVH) reduction and 24-hour blood pressure control of Valsartan 80mg or Nebivolol/Valsartan 5/80mg once daily as replacement therapy for currently treated or untreated hypertensive patients with LVH not at BP goal.
Detailed Description
The potential benefits of blood pressure reduction have been demonstrated in numerous large clinical trials. The most recent is the SPRINT Trial demonstrating that lower blood pressure goals can be achieved and are associated with a significant decrease in morbidity and mortality. The latest NHANES 2012 data reveal that less than 50% of patients that are aware of the elevated blood pressure and are being treated achieve blood pressure control. Treatment of hypertension in many patients (>70%) require treatment with more than one drug, increasing the likelihood of non-compliance and not achieving blood pressure goal. JNC 8 recommends the utilizing of combination therapy both for Stage I and Stage II Hypertensive patients. Objectives of the study to assess the efficacy of LVH reduction and 24-hour blood pressure control of Valsartan 80mg and Nebivolol/Valsartan 5/80mg, once daily for the treatment of currently treated hypertensive patients with LVH. The study will evaluate LVH reduction at 4 and 8 weeks as well as change from baseline in mean 24 hour ABPM SBP after 4 and 8 weeks of treatment with valsartan 80mg or nebivolol/valsartan 5/80mg

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertension Complicated, Hypertrophy, Left Ventricular, Blood Pressure

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Model Description
Prospective, randomized, open label, blinded-endpoint (PROBE)
Masking
Investigator
Masking Description
alternating
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Valsartan Arm
Arm Type
Active Comparator
Arm Description
Valsartan 80mg randomly assigned for 8 weeks to asses BP control with office and 24-hour ABPM and reduction of LVH
Arm Title
Nebivolol/Valsartan
Arm Type
Active Comparator
Arm Description
Nebivolol/Valsartan 5/80mg randomly assigned for 8 weeks to asses Blood Pressure control with office and 24-hour Ambulatory Blood Pressure Monitoring and reduction of Left Ventricular Hypertrophy
Intervention Type
Drug
Intervention Name(s)
Valsartan 80 mg
Other Intervention Name(s)
Nebivolol/Valsartan 5/80mg
Intervention Description
Compare office and 24-hour Blood Pressure Control and regression of Left Ventricular Hypertrophy
Primary Outcome Measure Information:
Title
LVH reduction at 4 weeks.
Description
Reduction of Left ventricular hypertrophy from baseline compared to 4 weeks of treatment
Time Frame
4 weeks
Title
24hr-ABPM measurement Change from baseline in mean 24 hour ABPM SBP
Description
Reduction of Systolic BP over 24 hours baseline compared to 4 weeks of treatment
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
LVH reduction at 8 weeks.
Description
Reduction of Left ventricular hypertrophy from baseline compared to 8 weeks of treatment
Time Frame
8 weeks
Title
24hr-Systolic ABPM measurement
Description
Reduction of Systolic BP over 24 hours baseline compared to 8 weeks of treatment
Time Frame
8 weeks
Title
24hr- DBP ABPM measurements
Description
Mean change from baseline in trough DBP after 4 and 8 weeks of treatment with valsartan 80mg or nebivolol/valsartan 5/80mg
Time Frame
4 and 8 weeks
Title
Office Blood Pressure measurements
Description
Mean change from baseline in trough SBP after 4 and 8 weeks of treatment with valsartan 80mg or nebivolol/valsartan 5/80mg
Time Frame
4 and 8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Capable of reading, comprehending the consent process and providing written informed consent to participate in the study. Male or female ≥ 18 years of age who are either newly diagnosed with HTN or who are currently being treated. Patients must have a mean cuff sitting diastolic blood pressure cuff (DBP) > 90 mmHg and <105 mmHg (< 100 mmHg on prior treatment) and mean cuff sitting systolic blood pressure (SBP) <160 mmHg, at two consecutive qualifying visits during the placebo run in period. Arm circumference < 45cm. Compliance with single blind placebo capsules between V1 to 4 or 4X of 80-120%. Women may be enrolled if the following criteria are met: 1.- Have a negative serum pregnancy test at screening 2.- Are not breastfeeding 3.- Do not plan to become pregnant during the study 4.- Have had a hysterectomy or tubal ligation at least 6 months prior to signing the informed consent form or 5.- Have been postmenopausal for at least 1 year or 6. - If they are of childbearing potential and will practice one of the following methods of birth control throughout the study: oral, patch, injectable, or implantable hormone contraception, intrauterine device, diaphragm plus spermicide or female condom plus spermicide. Abstinence, partner's vasectomy are not acceptable methods of contraception. 7. Diagnosis of Left Ventricular Hypertrophy (LVH). Exclusion Criteria: Known allergy or hypersensitivity to Beta-Blockers. Known allergy or hypersensitivity to Angiotensin II Receptor Blockers. Patients with severe hypertension (mean seated cuff DBP>115 mmHg or mean seated SBP> 180mmHg) or any form of secondary hypertension. Patients within the past 6 months with a history of hypertensive encephalopathy, stroke or transient ischemic attack. Patients within the last 6 months with a history of myocardial infarction, percutaneous transluminal coronary revascularization, coronary bypass graft, valvular surgery or unstable angina. Patients with evidence of resting bradycardia (<50 bpm) via palpation. Patients with a history of heart block greater than First Degree Sino-atrial Block. Wolff-Parkinson-White Syndrome, Sick Sinus Syndrome, Atrial Fibrillation, Atrial Flutter, Congestive Heart Failure, or other manifestations of clinically significant cardiac valvular disease. Patients with hemodynamically significant cardiac valvular disease. Patients with evidence of significant chronic renal impairment as indicated by a serum creatinine of > 2.5mg/dL. Patients with evidence of liver disease as indicated by AST (SGOT) or ALT (SGPT) > 2.5 times or total bilirubin > 1.5 times, the upper limit of the laboratory normal range. Patients who demonstrate other laboratory test values deviating from the normal range which are considered to be clinically significant by the investigator. Patient with a history or presence of gastrointestinal disease which may interfere with drug absorption. Patients with insulin and non-insulin dependent diabetes mellitus not controlled on diet, insulin, or oral hypoglycemics as defined by a HgA1c >10. Severe psychological or emotional condition which may interfere with participation in the study. History of or current use of illicit drugs or alcohol abuse. Participation in a clinical trial and taking any investigational drug within 30 days prior to enrolling into the study (Screening Visit). A physical condition that would limit accurate BP measurement. Inability to swallow a tablet or capsule. History of moderate or severe asthma or COPD. Any other medical condition which, in the Investigator's opinion, may render the patient unable to complete the study or which would interfere with optimal participation in the study or produce significant risk to the patient. Patients taking more than two blood pressure medications Patients currently taking a beta blocker -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Henry A Punzi, MD
Organizational Affiliation
UT Southwestern Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Trinity Hypertension & Metabolic Research Institute
City
Carrollton
State/Province
Texas
ZIP/Postal Code
75006
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Efficacy and Safety of Valsartan and Nebivolol/Valsartan in Hypertensive Patients With LVH

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