In the vast, climate-controlled vaults of the University of Utah, tens of thousands of blood samples rest in suspended animation, preserved for years as a priceless scientific cache. These samples derive from the SPRINT trial, one of the largest and most comprehensive clinical studies focusing on intensive blood pressure management and its effects on overall health. Now, a groundbreaking initiative, fueled by a substantial $21.6 million grant from the National Institutes of Health, aims to delve deep into these frozen reservoirs to unmask the intricate biological connections tying hypertension to brain health, with an emphasis on Alzheimer’s disease and dementia.
Hypertension, or high blood pressure, is long recognized as a significant modifiable risk factor for multiple cardiovascular and neurological conditions. Among older adults, its role in cognitive decline is particularly concerning. Alzheimer’s disease — the most common form of dementia — is characterized by the progressive buildup of specific protein aggregates such as amyloid plaques and neurofibrillary tangles, which disrupt neuronal communication and trigger widespread neurodegeneration. However, vascular pathology originating from chronic hypertension can also compromise cerebral blood flow and exacerbate cognitive impairments. The precise mechanistic pathways through which elevated blood pressure amplifies dementia risk remain an area of active inquiry, one that this new study hopes to illuminate.
By applying state-of-the-art biomolecular technologies, researchers are targeting novel blood-based biomarkers capable of detecting Alzheimer’s disease pathology with a diagnostic fidelity nearly equivalent to invasive cerebrospinal fluid sampling or costly brain positron emission tomography (PET) scans. These sensitive molecular indicators, present in minute concentrations, serve as proxies for underlying neurodegenerative processes, allowing for minimally invasive, scalable detection across large populations. The project plans to interrogate these biomarker profiles across tens of thousands of archived samples, cross-referencing them with extensive clinical data collected during the SPRINT trial to evaluate longitudinal outcomes related to cognition and dementia.
Integral to this endeavor is the exploration of how intensive blood pressure control — beyond standard therapeutic targets — modulates the trajectory of brain health. Current clinical guidelines often prioritize cardiovascular risk reduction, yet the benefits and potential trade-offs of aggressive hypertension management on neurodegeneration are not fully delineated. By evaluating biomarker shifts in participants subjected to varying blood pressure interventions, scientists aim to decode whether reductions in cerebral small vessel disease, inflammation, or amyloid pathology mediate observed cognitive outcomes.
Moreover, this research addresses the complex interplay between genetic predisposition and therapeutic efficacy. Genomic variants associated with Alzheimer’s risk, such as those in the APOE gene, likely impact individual susceptibility to both neurodegeneration and hypertension-related vascular injury. The investigators will dissect whether patients harboring these genetic susceptibilities derive equal or differential benefits from intensified blood pressure regimes, potentially paving the way for personalized medicine strategies tailored to genetic and phenotypic profiles.
Rachel Hess, MD, associate vice president for research at U of U Health, underscores the unique value of the SPRINT biobank. The preservation of biospecimens from thousands of participants over a decade provides an unprecedented resource enabling retrospective analyses using biomarkers developed long after initial sample collection. This biobank thus serves as a bridge between historic clinical trials and emerging molecular technologies, offering novel insights into how blood pressure modulation influences neurodegenerative disease progression in real-world populations.
The collaborative nature of the study expands its translational impact. Jeremy Pruzin, MD, a behavioral neurologist at Banner Alzheimer’s Institute, highlights the potential for study outcomes to refine clinical decision-making. By delineating risk profiles where hypertension contributes most significantly to dementia, clinicians can tailor antihypertensive therapies not only to prevent stroke or cardiac events but as a strategic intervention to preserve cognitive function.
Adam Bress, PharmD, one of the principal investigators, emphasizes the commitment to open science and data transparency. The project will publicly release a rich dataset encompassing multiple blood biomarkers, cognitive assessments, and longitudinal dementia diagnoses. This repository is poised to become one of the largest and most comprehensive of its type worldwide, catalyzing further research across neurology, cardiology, and epidemiology disciplines.
Jasmeer Chhatwal, MD, PhD from Harvard Medical School, notes the transformative potential of these advancements. Blood-based neurodegenerative biomarkers are set to revolutionize clinical practice by facilitating scalable screening and diagnosis. Implementing these tools in diverse real-world settings will enable earlier intervention and potentially slow disease progression through modifiable factors such as hypertension.
Angela Fagerlin, PhD, chair of population health sciences at U of U Health, contextualizes the project’s broader public health implications. By integrating molecular diagnostics with clinical trials, the study aims to uncover actionable pathways to protect cognitive health and sustain independence in aging populations. This fusion of innovation stands to not only enhance scientific understanding but also to foster precision care models that improve quality of life for millions at risk.
Overall, this initiative signifies a pivotal step forward in unraveling the multifaceted connections between cardiovascular health and neurodegeneration. It harnesses cutting-edge biomarker science, robust clinical trial frameworks, and interdisciplinary expertise to interrogate how the management of a common yet devastating risk factor — hypertension — can alter the landscape of cognitive aging. As the scientific community anticipates the study’s revelations, the promise of more effective, individualized therapies for dementia looms on the horizon.
Subject of Research: The relationship between hypertension management and brain health, focusing on Alzheimer’s disease and dementia using blood biomarkers.
Article Title: Unlocking the Blood-Brain Connection: How Intensive Hypertension Treatment Could Alter the Course of Dementia
News Publication Date: Not specified
Web References:
- University of Utah Health: https://medicine.utah.edu/faculty/adam-bress
- Jasmeer Chhatwal profile: https://brain.harvard.edu/?people=jasmeer-chhatwal
- Jeremy Pruzin profile: https://doctors.bannerhealth.com/provider/jeremy-pruzin/1642337
Image Credits: Charlie Ehlert / University of Utah Health
Keywords: Hypertension, Alzheimer disease, Dementia, Blood biomarkers, Neurodegenerative diseases, Clinical trials, Population health, Cognitive decline
