Trial Outcomes & Findings for The Effect of Nebivolol on Endothelial Dysfunction in African Americans With Hypertension (NCT NCT01049009)

NCT ID: NCT01049009

Last Updated: 2017-04-11

Results Overview

Forearm blood flow measured by venous occlusion plethysmography at rest, after administration of N(G)-monomethyl-L-arginine (L-NMMA) and tetraethylammonium chloride (TEA), after administration of L-NMMA, TEA, and acetylcholine, and after administration of L-NMMA, TEA, and exercise. Unit of Measure refers to volume of blood (mL) per 100 mL of forearm tissue per minute.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

91 participants

Primary outcome timeframe

12 weeks

Results posted on

2017-04-11

Participant Flow

Subjects recruited from the general medical clinics of The Emory Clinic, Emory University Hospital, and Grady Memorial Hospital between January 2010 through January 2012.

91 subjects were enrolled but 47 subjects were withdrawn prior to group assignment due to various factors, which included eligibility criteria, lost to follow-up, and withdrawal by subject.

Participant milestones

Participant milestones
Measure
Nebivolol/Metoprolol XL
Subjects are randomized to Nebivolol 5mg and titrate to Nebivolol 10mg two weeks after drug initiation. Ten weeks after titration subjects will cross over to Metoprolol XL 50mg and titrate to Metoprolol XL 100mg two weeks after cross over.
Metoprolol XL/Nebivolol
Subjects are randomized to Metoprolol XL 50mg and titrate to Metoprolol XL 100mg two weeks after drug initiation. Ten weeks after titration subjects will cross over to Nebivolol 5mg and titrate to Nebivolol 10mg two weeks after cross over.
Treatment Period 1 (12 Weeks)
STARTED
23
21
Treatment Period 1 (12 Weeks)
COMPLETED
21
18
Treatment Period 1 (12 Weeks)
NOT COMPLETED
2
3
Treatment Period 2 (12 Weeks)
STARTED
21
18
Treatment Period 2 (12 Weeks)
COMPLETED
11
8
Treatment Period 2 (12 Weeks)
NOT COMPLETED
10
10

Reasons for withdrawal

Reasons for withdrawal
Measure
Nebivolol/Metoprolol XL
Subjects are randomized to Nebivolol 5mg and titrate to Nebivolol 10mg two weeks after drug initiation. Ten weeks after titration subjects will cross over to Metoprolol XL 50mg and titrate to Metoprolol XL 100mg two weeks after cross over.
Metoprolol XL/Nebivolol
Subjects are randomized to Metoprolol XL 50mg and titrate to Metoprolol XL 100mg two weeks after drug initiation. Ten weeks after titration subjects will cross over to Nebivolol 5mg and titrate to Nebivolol 10mg two weeks after cross over.
Treatment Period 1 (12 Weeks)
Protocol Violation
2
2
Treatment Period 1 (12 Weeks)
Lost to Follow-up
0
1
Treatment Period 2 (12 Weeks)
Lost to Follow-up
2
3
Treatment Period 2 (12 Weeks)
Protocol Violation
8
7

Baseline Characteristics

The Effect of Nebivolol on Endothelial Dysfunction in African Americans With Hypertension

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Nebivolol/Metoprolol XL
n=11 Participants
Subjects were randomized to Nebivolol 5mg and titrated to Nebivolol 10mg two weeks after drug initiation. Ten weeks after titration, subjects crossed over to Metoprolol XL 50mg and titrated to Metoprolol XL 100mg two weeks after cross over.
Metoprolol XL/Nebivolol
n=8 Participants
Subjects were randomized to Metoprolol XL 50mg and titrated to Metoprolol XL 100mg two weeks after drug initiation. Ten weeks after titration, subjects crossed over to Nebivolol 5mg and titrated to Nebivolol 10mg two weeks after cross over.
Total
n=19 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
11 Participants
n=5 Participants
8 Participants
n=7 Participants
19 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Sex: Female, Male
Female
4 Participants
n=5 Participants
2 Participants
n=7 Participants
6 Participants
n=5 Participants
Sex: Female, Male
Male
7 Participants
n=5 Participants
6 Participants
n=7 Participants
13 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 12 weeks

Forearm blood flow measured by venous occlusion plethysmography at rest, after administration of N(G)-monomethyl-L-arginine (L-NMMA) and tetraethylammonium chloride (TEA), after administration of L-NMMA, TEA, and acetylcholine, and after administration of L-NMMA, TEA, and exercise. Unit of Measure refers to volume of blood (mL) per 100 mL of forearm tissue per minute.

Outcome measures

Outcome measures
Measure
Nebivolol/Metoprolol XL
n=11 Participants
Subjects were randomized to Nebivolol 5mg and titrated to Nebivolol 10mg two weeks after drug initiation. Ten weeks after titration, subjects crossed over to Metoprolol XL 50mg and titrated to Metoprolol XL 100mg two weeks after cross over.
Metoprolol XL/Nebivolol
n=8 Participants
Subjects were randomized to Metoprolol XL 50mg and titrated to Metoprolol XL 100mg two weeks after drug initiation. Ten weeks after titration, subjects crossed over to Nebivolol 5mg and titrated to Nebivolol 10mg two weeks after cross over.
Endothelial Function Measured by Forearm Blood Flow (FBF) at 12 Weeks
At rest
2.739 mL/100 mL/min
Standard Deviation 1.365
2.679 mL/100 mL/min
Standard Deviation .0901
Endothelial Function Measured by Forearm Blood Flow (FBF) at 12 Weeks
L-NMMA+TEA
1.963 mL/100 mL/min
Standard Deviation 0.968
2.221 mL/100 mL/min
Standard Deviation 0.630
Endothelial Function Measured by Forearm Blood Flow (FBF) at 12 Weeks
L-NMMA+TEA+ACh
5.376 mL/100 mL/min
Standard Deviation 3.362
7.562 mL/100 mL/min
Standard Deviation 4.358
Endothelial Function Measured by Forearm Blood Flow (FBF) at 12 Weeks
L-NMMA+TEA+exercise
7.377 mL/100 mL/min
Standard Deviation 2.754
11.574 mL/100 mL/min
Standard Deviation 4.716

PRIMARY outcome

Timeframe: 24 weeks

Forearm blood flow measured by venous occlusion plethysmography at rest, after administration of N(G)-monomethyl-L-arginine (L-NMMA) and tetraethylammonium chloride (TEA), after administration of L-NMMA, TEA, and acetylcholine, and after administration of L-NMMA, TEA, and exercise. Unit of Measure refers to volume of blood (mL) per 100 mL of forearm tissue per minute.

Outcome measures

Outcome measures
Measure
Nebivolol/Metoprolol XL
n=11 Participants
Subjects were randomized to Nebivolol 5mg and titrated to Nebivolol 10mg two weeks after drug initiation. Ten weeks after titration, subjects crossed over to Metoprolol XL 50mg and titrated to Metoprolol XL 100mg two weeks after cross over.
Metoprolol XL/Nebivolol
n=8 Participants
Subjects were randomized to Metoprolol XL 50mg and titrated to Metoprolol XL 100mg two weeks after drug initiation. Ten weeks after titration, subjects crossed over to Nebivolol 5mg and titrated to Nebivolol 10mg two weeks after cross over.
Endothelial Function Measured by Forearm Blood Flow (FBF) at 24 Weeks
L-NMMA+TEA+ACh
7.158 mL/100 mL/min
Standard Deviation 4.875
7.534 mL/100 mL/min
Standard Deviation 4.523
Endothelial Function Measured by Forearm Blood Flow (FBF) at 24 Weeks
At rest
3.066 mL/100 mL/min
Standard Deviation 1.469
2.968 mL/100 mL/min
Standard Deviation 1.164
Endothelial Function Measured by Forearm Blood Flow (FBF) at 24 Weeks
L-NMMA+TEA
2.457 mL/100 mL/min
Standard Deviation 1.549
2.287 mL/100 mL/min
Standard Deviation 0.693
Endothelial Function Measured by Forearm Blood Flow (FBF) at 24 Weeks
L-NMMA+TEA+exercise
9.589 mL/100 mL/min
Standard Deviation 3.550
10.395 mL/100 mL/min
Standard Deviation 2.687

Adverse Events

Nebivolol/Metoprolol XL

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Metoprolol XL/Nebivolol

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Arshed A. Quyyumi

Emory University School of Medicine

Phone: 404-727-3655

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place