Comparing two beta blockers for heart health in dialysis patients

CSP #2026 - Beta Blocker Dialyzability on Cardiovascular Outcomes (BRAVO)

Phase 3 Interventional VA Office of Research and Development · NCT05931276

This study is testing which beta blocker, metoprolol or carvedilol, is better for heart health in veterans on dialysis to see if it can help them live longer and feel better.

Quick facts

PhasePhase 3
Study typeInterventional
Enrollment2540 (estimated)
Ages18 Years and up
SexAll
SponsorVA Office of Research and Development Federal
Locations8 sites (Long Beach, California and 7 other locations)
Trial IDNCT05931276 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to compare the cardiovascular outcomes of hemodialysis patients treated with metoprolol succinate, a dialyzable beta blocker, versus carvedilol, a non-dialyzable beta blocker. Approximately 35,000 Veterans with end-stage kidney disease will be involved, as they face high cardiovascular morbidity and mortality rates. The study will utilize a point-of-care randomized controlled trial design to assess which medication leads to better survival rates and overall heart health. Additionally, the trial will explore practices that enhance patient engagement and treatment sustainability.

Who should consider this trial

Good fit: Ideal candidates include hemodialysis patients who are currently receiving beta blockers through the VA pharmacy.

Not a fit: Patients with impaired decision-making capacity or those not receiving carvedilol who have a history of asthma may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved cardiovascular outcomes and reduced mortality for dialysis patients.

How similar studies have performed: While there have been observational studies suggesting better outcomes with metoprolol, this is the first head-to-head randomized trial comparing these two beta blockers in end-stage kidney disease patients.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* On hemodialysis
* Received one of the following beta blockers through the VA pharmacy: metoprolol (succinate or tartrate), atenolol, labetalol, carvedilol, bisoprolol

Exclusion Criteria:

* Impaired decision-making capacity
* Patients not receiving carvedilol who have a history of asthma
* known hypersensitivity to any component of either drug
* Provider unwilling to sign a new medication order for a randomized patient
* No surrogate consent will be allowed

Where this trial is running

Long Beach, California and 7 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions End-Stage Kidney DiseaseEnd-Stage Renal DiseaseDialysisbeta-Blockers, AdrenergicCardiovascular DiseasesPoint of Care ResearchComparative Effectiveness ResearchMetoprolol Succinate
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.