Vascular Intervention Strategies Trial for Alzheimer's

Vascular Intervention Strategies Trial for Alzheimer's (VISTA)

The proposed pharmacist-led study is a feasibility pilot trial for the management of vascular risk factors of hypertension and hypercholesterolemia in 10 APOE ε4 carriers, 50-75, at-risk for dementia. All participants will receive angiotensin receptor blockers (ARBs) for high blood pressure, and hydrophilic statins (or a non-statin alternative) for high cholesterol over a six-month period.

Inclusion Criteria:

• APOE ε4 carrier (homozygote or heterozygote)
• LDL-C of 100-250 mg/dL
• Systolic blood Pressure (SBP) 130-180 mm Hg
• Age 50-75 years
• Fluency in English
• No dementia based on medical record review
• Male or post-menopausal female

Exclusion Criteria:

• One minute standing SBP < 110 mm Hg
• Arm circumference prevents from accurate BP measurement with use of available devices
• Lost weight of > 10% unintendedly (within the past 6 months),
• Contraindications to blood pressure and cholesterol lowering medications
• Use of medications prescribed for dementia (e.g., aducanumab, donanemab, lecanemab, donepezil, galantamine, rivastigmine, memantine)
• Evidence of dementia based on medical record review
• Living in a skilled nursing or rehabilitation facility
• Receiving palliative or hospice care
• Bipolar illness or schizophrenia
• Drug or alcohol disorder
• Receiving chronic opioid therapy
• Any significant neurological disease (e.g., Parkinson's disease, amyotrophic lateral sclerosis, or multiple sclerosis)
• Severe loss of visual, hearing or communication ability
• Organ transplant
• History of stroke, symptomatic HF or left ventricular ejection fraction < 35%
• ESRD or eGFR < 20 ml/min /1.73m2
• Does not consent to be contacted or to have their medical record reviewed for research purposes
• Concurrent participation in another clinical trial