Effect of Nebivolol on the Blood Flow in Hearts of Adults With High Blood Pressure and Abnormal Filling of Heart
Condition: Hypertension; Left Ventricular Diastolic Dysfunction
MeSH terms: Hypertension; Ventricular Dysfunction, Left
Intervention: Nebivolol
Intervention description: Doses will be titrated based on weekly visits during the first 2 weeks to achieve a target SBP<140 and DBP <90 mm Hg. If BP remains uncontrolled after 2 weeks of treatment, indapamide will be added at a dosage of 2.5 mg/day. If the therapeutic goal is still not achieved by 4 weeks, patients will be withdrawn from the study.Upward titration will be halted, and the previous dosage level resumed, if at any point systolic blood pressure falls to ≤ 100 mmHg, even if the individual remains asymptomatic.
Intervention MeSH terms: Nebivolol
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 70.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: Hypertension; high blood pressure; stress echocardiogram; nebivolol; left ventricular diastolic dysfunction

Summary:

      To investigate whether treatment with Nebivolol in subjects with high blood pressure and
      abnormal filling of left ventricle (LVDD) improves exercise time by improving Left
      Ventricular deformation and filling.
    

Eligibility criteria:

        Inclusion Criteria:

          -  History of mild (140-160 / 90-100) to moderate (160-200 / 100-120) hypertension

          -  LV diastolic dysfunction (>/= Grade1)

          -  LV ejection fraction >50%

          -  Indexed left atrial volume >/= 28 mL/m^2

          -  In sinus rhythm at the time of enrollment

          -  Willingness to return for the 6-month follow up investigations

        Exclusion Criteria:

          -  Presence or history of any of the following at baseline:

               1. History of mitral valve disease of greater than mild severity or prosthetic
                  mitral valve, congenital heart disease or permanent pacemaker

               2. Calculated creatinine clearance <50 mL/min

               3. Terminal Illness with expected Survival of <1 year

               4. Previous Heart Transplant

               5. Individuals who are institutionalized

               6. Systolic BP>180 mm Hg or diastolic BP > 120 mm Hg

          -  Medical treatment for elevated BP with:

               1. Calcium channel blocker (e.g. verapamil, nifedipine);

               2. Alpha blocker (e.g. prazosin);

               3. Alpha agonist (e.g. α-methyldopa, hydralazine, clonidine)

          -  Patient unwilling or unable to provide informed consent for study participation

          -  Pregnancy (current, or anticipated within the study period)

          -  Secondary Hypertension

          -  Previous echo contrast allergy

          -  Poor echocardiography window

          -  Previous stroke, known carotid stenosis

          -  Contraindication for beta-blocker therapy (sinus bradycardia <50 beats/min);

          -  2nd or 3rd degree AV conduction block

          -  Overt congestive cardiac failure (NYHA Class III-IV)

          -  Known bronchospastic disease

          -  Known hepatic dysfunction (SGOT/PT > twice above normal levels)