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

Korábbi kezelés

• Unstable heart disease based on clinical judgment (heart attack/cardiac arrest, cardiac bypass procedures within previous 6 months and congestive heart failure), evidence of atrial fibrillation on ECG, or other severe medical conditions;
• Participants enrolled in another investigational drug or device study within the past 2 months;

Más betegség

• History of stroke, transient ischemic attack, traumatic brain injury or severe cerebrovascular disease by clinical diagnosis or past MRI/CT;
• Diagnosis of AD or other type of dementia and neurodegenerative diseases;
• History of significant autoimmune disorders such as systemic lupus erythematosus, rheumatoid arthritis and polymyalgia rheumatica;
• History of drug or alcohol abuse within the last 2 years;
• History of B12 deficiency or hypothyroidism (stable treatment for at least 3 months is allowable);
• Any conditions judged by the study investigators to be either medically inappropriate, or risky for participant or likely to have poor study adherence;

Laborértékek

• Chronic kidney diseases with GFR < 40 ml/min;
• Diagnosis of uncontrolled diabetes mellitus (fasting blood sugar ≥126 mg/dL or A1C >7.5%)

Egyéb

• Evidence of severe depression or other DSM-V Axis I psychopathology
• Orthostatic hypotension, defined as standing SBP<100 mmHg;
• Obstructive sleep apnea;
• Regularly smoking cigarette within the past year;
• Severe obesity with BMI ≥ 45;
• Carotid stent or sever stenosis (> 50%);
• Pacemaker or other medical device of metal that precludes performing MRI;
• Claustrophobia;
• Pregnancy

• Age 55-79, all races/ethnicities, and both women and men are eligible;
• Mini-mental state exam (MMSE) > 26 to exclude cognitive impairment or dementia;
• Healthy normotensive subjects (24-hour ambulatory BP<125/75 mmHg without use of antihypertensive medication);
• Patients with hypertension defined as 24-hour SBP ≥130 mmHg , patients on BP medications are eligible;
• Patients with hypertension are willing to be randomized into either treatment group and ability to return to clinic or laboratory for follow-up visits over 12 months;
• Fluency in English, adequate visual and auditory acuity to allow neuropsychological testing;
• Screening laboratory tests and ECG without significant abnormalities that might interfere with the study