The Effects of Systolic Blood Pressure Lowering on Diastolic Function Using Valsartan + Amlodipine in Patients With Hypertension and Diastolic Dysfunction

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Novartis ( Novartis Pharmaceuticals )
ClinicalTrials.gov Identifier:
NCT00523549
First received: August 30, 2007
Last updated: April 19, 2012
Last verified: April 2012
  Purpose

The purpose of this study is to determine the effects of treatment with valsartan + amlodipine to a target systolic blood pressure (SBP)<130 mmHg compared to the Joint National Commission on the Treatment of Hypertension 7 recommended target SBP of <140 mmHg on the intrinsic diastolic properties of the myocardium in patients with hypertension and echocardiographic evidence of diastolic dysfunction.


Condition Intervention Phase
Hypertension
Diastolic Dysfunction
Drug: valsartan
Drug: amlodipine
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Multi-center, Prospective, Randomized, Open-label Study With Blinded Outcome Evaluation to Evaluate the Effects of Systolic Blood Pressure Lowering to Different Targets (Less Than 130 mmHg vs. Less Than 140 mmHg) on Diastolic Function Using Valsartan + Amlodipine in Patients With Hypertension and Diastolic Dysfunction

Resource links provided by NLM:


Further study details as provided by Novartis:

Primary Outcome Measures:
  • Change in Lateral Mitral Annular Myocardial Relaxation Velocity [ Time Frame: Baseline to 24 weeks after treatment ] [ Designated as safety issue: No ]
    Change from baseline in lateral mitral annular myocardial relaxation velocity (E') at Week 24


Secondary Outcome Measures:
  • Change in Left Atrial Size [ Time Frame: Baseline to 24 weeks after treatment ] [ Designated as safety issue: No ]
    Change from baseline in left atrial size at Week 24

  • Change in Ratio of Peak E Wave Velocity/Lateral Mitral Annular Myocardial Relaxation Velocity [ Time Frame: Baseline to 24 weeks after treatment ] [ Designated as safety issue: No ]
    Change from baseline in peak E-wave velocity / lateral mitral annular myocardial relaxation velocity (E/E') at Week 24

  • Percent Change From Baseline in Vascular Stiffness [ Time Frame: Baseline to 8 and 24 weeks after treatment ] [ Designated as safety issue: No ]
    Percent change from baseline in Vascular Stiffness (measured by radial augmentation index [AI]) at Weeks 8 and 24

  • Change in Mean Sitting Systolic Blood Pressure (msSBP) [ Time Frame: Baseline to 8 and 24 weeks after treatment ] [ Designated as safety issue: No ]
    Change from baseline in msSBP at Weeks 8 and 24

  • Change in Mean Sitting Diastolic Blood Pressure (msDBP) [ Time Frame: Baseline to 8 and 24 weeks after treatment ] [ Designated as safety issue: No ]
    Change from baseline in msDBP at Weeks 8 and 24

  • Change in Estimated Central Aortic Pressure [ Time Frame: Baseline to 8 and 24 weeks after treatment ] [ Designated as safety issue: No ]
    Change from baseline in estimated central aortic pressure at Weeks 8 and 24


Enrollment: 229
Study Start Date: November 2006
Study Completion Date: January 2008
Primary Completion Date: January 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Standard treatment regimen
(Valsartan + Amlodipine to target SBP of < 140 mmHg)
Drug: valsartan
160 mg or 320 mg tablets once a day
Other Name: Diovan
Drug: amlodipine
5 mg or 10 mg tablets once a day
Other Name: Norvasc
Experimental: Intensive treatment regimen
(Valsartan + Amlodipine to target SBP < 130 mm Hg)
Drug: valsartan
160 mg or 320 mg tablets once a day
Other Name: Diovan
Drug: amlodipine
5 mg or 10 mg tablets once a day
Other Name: Norvasc

  Eligibility

Ages Eligible for Study:   45 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 45 years or older
  • Male and female patients are eligible. Female patients must be post-menopausal for one year, surgically sterile, or using effective contraceptive methods such as a double barrier method with spermicide, an intra-uterine device, or hormonal contraceptives. Post-menopausal women on a stable dose of hormone replacement therapy (HRT) for at least three (3) months prior to the screening visit are eligible for the study.
  • Uncontrolled systolic hypertension on a maximum of two (2) antihypertensive medications at the time of screening.
  • Echocardiographic ejection fraction ≥50% and evidence of diastolic dysfunction.
  • Provide written informed consent to participate in the study prior to any screening or study procedures
  • Have the ability to communicate well and comply with all study requirements

Exclusion Criteria:

  • Severe hypertension defined as a MSSBP >200 mmHg and/or MSDBP >120 mmHg.
  • History of a secondary cause of hypertension including but not limited to: coarctation of the aorta, hyperaldosteronism, unilateral or bilateral renal artery stenosis, Cushing's disease, pheochromocytoma, polycystic kidney disease, etc.
  • Ejection fraction <50 %
  • History of stroke, transient ischemic attack, myocardial infarction, coronary artery bypass graft surgery, or unstable angina pectoris within 6 months of screening
  • Presence of clinically significant ventricular or supraventricular arrhythmias (e.g. atrial fibrillation/flutter)
  • History of congestive heart failure
  • History of diabetes mellitus
  • History of renal impairment with serum creatinine >2.0 mg/dL at screening, history of dialysis, or history of nephritic syndrome
  • Antihypertensive therapy with three (3) or more medications at the time of screening
  • Active and/or treated malignancy of any organ system within twelve (12) months of enrollment, with the exception of localized basal cell carcinoma of the skin
  • Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test (>5 mIU/ml)
  • Women of child-bearing potential (WOCBP), defined as all women physiologically capable of becoming pregnant, including women whose career, lifestyle, or sexual orientation precludes intercourse with a male partner and women whose partners have been sterilized by vasectomy or other means, UNLESS they meet the following definition of post-menopausal: 12 months of natural (spontaneous) amenorrhea or 6 months of spontaneous amenorrhea with serum FSH levels >40 mIU/m or 6 weeks post surgical bilateral oophorectomy with or without hysterectomy OR are using one or more of the following acceptable methods of contraception: barrier method with spermicidal agent, an intrauterine device, hormonal contraceptives, or total abstinence at the discretion of the investigator in cases where the age, career, lifestyle, or sexual orientation of the patient ensures compliance. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception. Reliable contraception should be maintained throughout the study
  • Any surgical or medical condition which might significantly alter the absorption, distribution, metabolism, or excretion of any drug including, but not limited to, any of the following: history of major gastrointestinal tract surgery such as gastrectomy, gastroenterostomy, bowel resection, gastric bypass, gastric stapling, or gastric banding, currently active, or active inflammatory bowel syndrome within 12 months prior to Visit 1, currently active gastritis, ulcers, or gastrointestinal/rectal bleeding, or urinary tract obstruction regarded as clinically meaningful by the investigator
  • Pancreatic injury, pancreatitis or evidence of impaired pancreatic function/injury within 12 months prior to Visit 1
  • Any serum AST or ALT elevation two (2) times the upper limit of normal

Other protocol-defined inclusion/exclusion criteria may apply

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00523549

Locations
United States, New Jersey
Novartis Investigative Sites
USA, New Jersey, United States
Sponsors and Collaborators
Novartis Pharmaceuticals
Investigators
Study Director: Novartis Pharmaceuticals Novartis Pharmaceuticals
  More Information

Publications:
Responsible Party: Novartis ( Novartis Pharmaceuticals )
ClinicalTrials.gov Identifier: NCT00523549     History of Changes
Other Study ID Numbers: CVAA489AUS01
Study First Received: August 30, 2007
Results First Received: December 6, 2010
Last Updated: April 19, 2012
Health Authority: United States: Food and Drug Administration

Keywords provided by Novartis:
Hypertension
systolic blood pressure
diastolic dysfunction
valsartan
amlodipine

Additional relevant MeSH terms:
Hypertension
Vascular Diseases
Cardiovascular Diseases
Valsartan
Amlodipine
Antihypertensive Agents
Cardiovascular Agents
Therapeutic Uses
Pharmacologic Actions
Calcium Channel Blockers
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Vasodilator Agents
Angiotensin II Type 1 Receptor Blockers
Angiotensin Receptor Antagonists

ClinicalTrials.gov processed this record on August 28, 2014