Effect of Nebivolol on Oxidative Stress and Endothelial Progenitor Cells
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Purpose
Hypertension, or high blood pressure, is a common disease that affects many Americans, and can lead to devastating consequences such as heart attack, stroke, and death if not treated. Nebivolol is a medication that has been recently approved by the FDA for the treatment of hypertension. Nebivolol has an unusual profile compared to other medications, in that its effects may be related to release of a substance called nitric oxide. Nitric oxide is released from the cells lining the blood vessels, and nebivolol may stimulate these cells to release more nitric oxide. Our study will investigate whether treatment with nebivolol, as compared to another medication called metoprolol, in hypertensive subjects will be more effective in protecting blood vessels against the harmful effects of high blood pressure. The mechanisms we will investigate include oxidative stress markers and circulating levels of endothelial progenitor cells.
| Condition | Intervention | Phase |
|---|---|---|
|
Hypertension |
Drug: Nebivolol Drug: Metoprolol succinate |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Treatment |
| Official Title: | Effect of Nebivolol on Oxidative Stress and Endothelial Progenitor Cells in Subjects With Hypertension |
- Nebivolol will improve vascular function (measured as arterial stiffness) by 1) improving markers of oxidative stress and 2) enhancing circulating EPC activity. [ Time Frame: 8 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 34 |
| Study Start Date: | December 2009 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Nebivolol |
Drug: Nebivolol
Subjects will be randomized to either nebivolol or metoprolol succinate, and remain on the study drug for 3 months. They will then "cross over" to take 3 months of the comparator drug.
Other Name: Bystolic
|
| Active Comparator: Toprol XL |
Drug: Metoprolol succinate
Subjects will be randomized to either nebivolol or metoprolol succinate, and remain on the study drug for 3 months. They will then "cross over" to take 3 months of the comparator drug.
Other Name: Toprol XL
|
Eligibility| Ages Eligible for Study: | 21 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Males or post-menopausal females aged 21-80 years.
- Hypertensive patients (BP >135/85) will be eligible to participate.
- Patients on current anti-hypertensive therapy that does not include beta blockade should have BP >135/85.
- Patients on anti-hypertensive therapy including beta blockade will have their beta blockers discontinued gradually over 2 weeks before enrolment.
- Concomitant therapy: Patients will be allowed to be on comcomitant therapy with aspirin, statins, thiazide diuretics, calcium antagonists (for treatment of hypertension), clonidine, vasodilators, or angiotensin antagonists. Patients will be on stable medical therapy for at least 2 months before recruitment. Patients with previous treatment with beta adrenergic blockers (metoprolol, propranolol, atenolol, and labetalol) will also be eligible to participate, but will be randomized to the study beta blocker.
Exclusion Criteria:
- Age < 21 or >80 years
- Initiation or change in dose of statin or anti-hypertensive therapy within 2 months before the study
- Premenopausal females with potential for pregnancy
- Acute infection in previous 2 weeks
- History of substance abuse
- Current neoplasm
- Chronic renal failure [creatinine > 2.5 mg/dL] or liver failure (Liver enzymes >2X normal)
- Acute coronary syndrome, Class IV heart failure, CVA, coronary intervention within 2 months
- Known aortic stenosis, hypertrophic cardiomyopathy.
- Inability to give informed consent
- Inability to return to Emory for follow-up testing
Contacts and Locations| Contact: Nino Kavtaradze | 404-712-0175 | nkavtar@emory.edu |
| Contact: Sherri McDonald | 404-712-2741 | SMCDON6@emory.edu |
| United States, Georgia | |
| Emory University | Recruiting |
| Atlanta, Georgia, United States, 30322 | |
| Principal Investigator: Arshed Quyyumi, MD | |
| Principal Investigator: | Arshed Quyyumi, MD | Emory University |
More Information
No publications provided
| Responsible Party: | Arshed A. Quyyumi, Professor, Emory University |
| ClinicalTrials.gov Identifier: | NCT01041287 History of Changes |
| Other Study ID Numbers: | BYD-MD-20 |
| Study First Received: | December 29, 2009 |
| Last Updated: | November 6, 2012 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Hypertension Vascular Diseases Cardiovascular Diseases Metoprolol Nebivolol Metoprolol succinate Anti-Arrhythmia Agents Cardiovascular Agents Therapeutic Uses Pharmacologic Actions Antihypertensive Agents |
Sympatholytics Autonomic Agents Peripheral Nervous System Agents Physiological Effects of Drugs Adrenergic beta-1 Receptor Antagonists Adrenergic beta-Antagonists Adrenergic Antagonists Adrenergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Vasodilator Agents |
ClinicalTrials.gov processed this record on June 17, 2013