Optimizing Blood Pressure Treatment in Older Veterans Using Arterial Stiffness and Genetic Testing

What this Trial Is About

This research aims to improve blood pressure treatment in older Veterans with hypertension by studying how different blood pressure goals affect arterial stiffness and exploring genetic factors. Hypertension is a common and treatable condition but remains a leading cause of heart disease. The study addresses the conflicting recommendations for blood pressure targets in older adults and focuses on better understanding individual differences in treatment response using novel non-invasive arterial stiffness measures and genetic analysis. Participants will be randomly assigned to receive either intensive blood pressure treatment targeting less than 120 mmHg systolic or standard treatment targeting less than 140 mmHg systolic. Treatment involves antihypertensive medications such as amlodipine, telmisartan, losartan, chlorthalidone, or spironolactone, adjusted according to the study protocol over 12 months. Arterial stiffness will be measured at baseline and at 3, 6, and 12 months using pulse wave velocity and ultrasound, with medications prescribed and adjusted at each visit. Throughout the 12-month study, participants will undergo regular evaluations including blood pressure monitoring, arterial stiffness assessments, carotid artery ultrasound, and genetic testing. Researchers will track medication adherence and serious side effects like hypotension or kidney injury. The main outcomes are changes in load-dependent and structural arterial stiffness, with additional measures including total arterial stiffness and brachial blood pressure. This trial seeks to personalize blood pressure care and improve cardiovascular health in older Veterans.

Arterial Stiffness and Blood Pressure