- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03354143
Hypertension, Intracranial Pulsatility and Brain Amyloid-beta Accumulation in Older Adults (HIPAC Trial) (HIPAC)
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.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Texas
-
Dallas, Texas, United States, 75390
- UT Southwestern Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 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
Exclusion Criteria:
- 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;
- Evidence of severe depression or other DSM-V Axis I psychopathology
- 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;
- Chronic kidney diseases with GFR < 40 ml/min;
- Orthostatic hypotension, defined as standing SBP<100 mmHg;
- 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;
- Diagnosis of uncontrolled diabetes mellitus (fasting blood sugar ≥126 mg/dL or A1C >7.5%)
- Obstructive sleep apnea;
- Regularly smoking cigarette within the past year;
- Severe obesity with BMI ≥ 45;
- Participants enrolled in another investigational drug or device study within the past 2 months;
- Carotid stent or sever stenosis (> 50%);
- Pacemaker or other medical device of metal that precludes performing MRI;
- 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;
- Claustrophobia;
- Pregnancy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
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.
|
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.
|
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.
|
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.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in intracranial pulsatility
Time Frame: Baseline and 12-months
|
Changes in intracranial pulsatility will be measured with CINE phase-contrast MRI
|
Baseline and 12-months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Cerebrospinal fluid Amyloid-β and tau
Time Frame: Baseline and 12-months
|
Baseline and 12-months
|
Global and regional brain perfusion via Magnetic Resonance Imaging (MRI)
Time Frame: Baseline and 12-months
|
Baseline and 12-months
|
Regional brain volume via Magnetic Resonance Imaging (MRI)
Time Frame: Baseline and 12-months
|
Baseline and 12-months
|
Regional cortical thickness via Magnetic Resonance Imaging (MRI)
Time Frame: Baseline and 12-months
|
Baseline and 12-months
|
Brain white matter hyperintensity (WMH) via Magnetic Resonance Imaging (MRI)
Time Frame: Baseline and 12-months
|
Baseline and 12-months
|
Brain white matter microstructural integrity via Magnetic Resonance Imaging (MRI)
Time Frame: Baseline and 12-months
|
Baseline and 12-months
|
Brain neural network functional connectivity via Magnetic Resonance Imaging (MRI)
Time Frame: Baseline and 12-months
|
Baseline and 12-months
|
NIH-Toolbox neurocognitive function
Time Frame: Baseline, 6-months,12-months
|
Baseline, 6-months,12-months
|
NIH PROMIS patient-reported outcome measures of physical health
Time Frame: Baseline, 6-months, 12-months
|
Baseline, 6-months, 12-months
|
NIH PROMIS patient-reported outcome measures of mental health
Time Frame: Baseline, 6-months, 12-months
|
Baseline, 6-months, 12-months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Rong Zhang, PhD, University of Texas Southwestern Medical Center and Texas Health Resources
- Principal Investigator: Wanpen Vongpatanasin, MD, University of Texas Southwestern Medical Center
- Principal Investigator: David Zhu, PhD, Michigan State University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- R01AG057571 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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