Hypertension, Intracranial Pulsatility and Brain Amyloid-beta Accumulation in Older Adults (HIPAC Trial)

Conditions

• Hypertension

Eligibility Criteria

Sex

ALL

Age

55 Years - 79 Years

Healthy Volunteers

Accepted

Interventions

• Standard Care — OTHER
  Calcium channel blocker (CCB, amlodipine), angiotensin II receptor blocker (ARB, losartan), and other antihypertensive drugs will be used to reduce 24-hour SBP ≤ 130 mmHg.
• Intensive Treatment — OTHER
  Calcium channel blocker (CCB, amlodipine), angiotensin II receptor blocker (ARB, losartan), and other antihypertensive drugs will be used to reduce 24-hour SBP ≤ 120 mmHg.

Study Details

The aim of this study is to determine if lowering blood pressure using FDA approved medication (antihypertensive drugs) alters brain pulsatility and reduces brain amyloid beta protein accumulation in older adults. Amyloid beta protein is high in the brain of older adults with Alzheimer's disease. Hypertension may increase brain amyloid beta protein accumulation and affect memory and thinking ability in older adults. However, whether lowering blood pressure reduces brain amyloid beta protein and improves brain function is inconclusive. The investigators hypothesize that treating high blood pressure alters brain pulsatility, which in turn reduces brain amyloid beta protein accumulation and improves brain structure and function.

Key Dates

Start date

Apr 10, 2018

Status verified

Jun 2025

Primary completion

Jan 22, 2024

Completion

Mar 30, 2024

Study Design

Enrollment

85 participants (actual)

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

PREVENTION

Arms

• Active Comparator: Standard Care
  Subjects in the standard care arm will receive calcium channel blocker (CCB, amlodipine), angiotensin II receptor blocker (ARB, losartan), and other antihypertensive drugs to reduce 24-hour SBP ≤ 130 mmHg. Drug doses will be titrated to reach the BP target.
• Experimental: Intensive Treatment
  Subjects in the intensive treatment arm will receive calcium channel blocker (CCB, amlodipine), angiotensin II receptor blocker (ARB, losartan), and other antihypertensive drugs to reduce 24-hour SBP ≤ 120 mmHg.
• No Intervention: Control group subjects
  Healthy normotensive subjects (24-hour ambulatory BP\<125/75 mmHg without use of antihypertensive medication) who undergo MRI as part of standard of care.

Primary Outcome Measure

Changes in Gray Matter Intracranial Pulsatility [ Time Frame: Baseline and 12-months ]

Locations (1)

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