Health Evaluation in African Americans Using RAS Therapy

This study will assess if Telmisartan, an FDA approved blood pressure medication, may also
have beneficial effects on Alzheimer's disease (AD) prevention in African Americans, who are
at high risk for Alzheimer's disease. Blood pressure medications known as
angiotensin-receptor blockers have been associated with reduced risk of Alzheimer's in
Caucasians because they act on the renin-angiotensin system (RAS), a key regulator of blood
pressure in the body and the brain. The drugs appear to slow the progression of the disease
by affecting flow of blood and the amount of plaque in the brain, but these benefits have not
been tested in African Americans. The investigator will evaluate if Telmisartan is able to
influence the renin-angiotensin system in the brain and produce favorable effects on brain
blood flow and enzymes that cause the brain plaques in Alzheimer's disease.The investigator
will assess the mechanism by which Telmisartan modifies the brain renin angiotensin system,
cerebrospinal fluid amyloid-β, cerebral blood flow (CBF) and inflammatory markers in
hypertensive African Americans.

Inclusion Criteria:

1. Treated hypertension (systolic blood pressure ≥ 110 mmHg systolic and ≤ 170 mmHg

2. Parent or biological family member with Alzheimer's disease

3. African American

Exclusion Criteria:

1. Mean resting blood pressure ≥110 and ≤ 170 mmHg systolic

2. Currently in another investigational drug study

3. Current use of renin-angiotensin acting medication

4. Potassium >5.5 meq/dl at baseline

5. Creatinine >1.99 mg/dl at baseline

6. History of stroke

7. Dementia

8. Baseline Montreal Cognitive Assessment score <27

9. Contraindication for lumbar puncture or magnetic resonance imaging

10. Heart failure

11. Diabetes Types I and II

12. Pregnant or nursing women