# Administrative Supplement: Effectiveness of Implementing an Intensive Blood Pressure Reduction Intervention on Cognitive Decline in Low-income and Minority Hypertensive Patients

> **NIH NIH R33** · TULANE UNIVERSITY OF LOUISIANA · 2022 · $414,148

## Abstract

Summary
African American and low-income populations bear a disproportionate burden of dementia and have been
underrepresented in trials of cognitive impairment. The Systolic Blood Pressure Intervention Trial (SPRINT)
showed that an intensive blood pressure (BP) intervention (target systolic BP <120 mmHg) lowered the risk of
cognitive impairment compared to a standard BP intervention (systolic BP target <140 mmHg). A next
important step is to determine how the successful SPRINT intensive blood pressure intervention can be
implemented in real-world clinic settings to prevent cognitive decline. The goal of the parent trial (IMPACTS-
MIND: R33AG068481) is to test a multifaceted strategy for implementing an intensive BP intervention protocol
adapted from SPRINT targeting systolic BP <120 mmHg on cognitive decline in racial minority and low-income
hypertensive patients in resource-constrained primary care practices. We have partnered with 36 federally
qualified health center clinics (FQHCs) in Louisiana and Mississippi to conduct a cluster-randomized trial to
test a multifaceted implementation strategy for an intensive BP intervention on decline in cognitive function and
implementation outcomes over an average of 42 months. To date and despite the pandemic and major
hurricanes, we have recruited and cognitively assessed 399 of an expected 1,260 diverse participants, and
data collection and intervention delivery are ongoing. The proposed administrative supplement will accomplish
two major objectives in support of the parent trial objectives and specific aims: 1) add 12 additional primary
care clinics (clusters) in order to speed up recruitment, enrich the study sample with older participants who are
more likely to experience cognitive change, and increase statistical power; and 2) provide antihypertensive
medications directly to intervention participants at no cost to improve the effectiveness of the intervention,
increase the net difference in BP reduction between groups, and improve retention. Overall, this administrative
supplement application is in line with and supports the original objective and aims of the parent study and will
improve trial conduct by: increasing speed of recruitment, enriching the sample for participants more likely to
have changes in the outcome of interest, increasing statistical power, increasing the effectiveness of the
intervention, and improving retention. The IMPACTS-MIND Data and Safety Monitoring Board (DSMB) has
recently made the following three recommendations for the trial (report attached): 1) adding additional sites, 2)
recruiting older participants, and 3) increasing the systolic BP separation by treatment arm. All of these
recommendations will be addressed by the proposed supplement objectives.

## Key facts

- **NIH application ID:** 10613808
- **Project number:** 3R33AG068481-03S1
- **Recipient organization:** TULANE UNIVERSITY OF LOUISIANA
- **Principal Investigator:** Jiang He
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $414,148
- **Award type:** 3
- **Project period:** 2020-08-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10613808

## Citation

> US National Institutes of Health, RePORTER application 10613808, Administrative Supplement: Effectiveness of Implementing an Intensive Blood Pressure Reduction Intervention on Cognitive Decline in Low-income and Minority Hypertensive Patients (3R33AG068481-03S1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10613808. Licensed CC0.

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