Dr. Hajjar is a geriatrician at Hebrew SeniorLife and an Instructor of Medicine at Harvard medical School. The candidate's long-term goal is to become an independent clinical investigator in the area of hypertension and aging by studying the role of the renin angiotensin system (RAS) and its genetics in cognitive and functional impairment and cerebral blood flow changes in the elderly. He will achieve this goal by a proposed career development plan that incorporates: mentorship by Dr. Lewis Lipsitz and a multidisciplinary (geriatrics, hypertension, neuropsychology, biostatistics, genetics, endocrinology, and gerontology) advisory committee; coursework in clinical trials, neurovascular ultrasonography, neuropsychology, and genetic epidemiology; training at neurovasuclar and neuropsychological laboratories; and conduct of a closely mentored patient-oriented research. Recent evidence suggests that RAS plays a role in aging. The candidate has demonstrated in observational studies that treatment with antihypertensives that inhibit RAS may slow down cognitive and functional decline with aging. The environment is academically rich and includes the various organizations and laboratories within the Harvard Medical School which will foster the scientific development and research skills to become an independent researcher. Under the mentorship of Dr. Lipsitz, the research plan is designed to gather preliminary data for future research activities. The first project is to conduct a pilot 3-arm randomized clinical trial of 6-month treatment with an angiotensin receptor blocker, an angiotensin converting enzyme inhibitor (ACEI), and a diuretic in seniors (n=100) with hypertension and objective evidence of early memory loss or executive dysfunction. The outcome measures include cognitive function, physical abilities and cerebral blood flow. The second project is to analyze data from the Health Aging and Body Composition survey to determine if a pharmacogenetic study is justifiable in the future research activities. This analysis will investigate the interaction between angiotensin converting enzyme gene polymorphism and the use of ACEI on cognitive decline in an aging population (n=3,075). Relevance: Findings from this project would provide new treatment modalities for elderly patients suffering from cognitive and physical impairment. It will also allow us to combine expertise from various fields to increase our understanding of the underlying mechanism by which cardiovascular disease affects aging.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Mentored Patient-Oriented Research Career Development Award (K23)
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National Institute on Aging Initial Review Group (NIA)
Program Officer
Wagster, Molly V
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University of Southern California
Internal Medicine/Medicine
Schools of Medicine
Los Angeles
United States
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Hajjar, Ihab; Sorond, Farzaneh; Lipsitz, Lewis A (2015) Apolipoprotein E, carbon dioxide vasoreactivity, and cognition in older adults: effect of hypertension. J Am Geriatr Soc 63:276-81
Hajjar, Ihab; Hart, Meaghan; Mack, Wendy et al. (2015) Aldosterone, cognitive function, and cerebral hemodynamics in hypertension and antihypertensive therapy. Am J Hypertens 28:319-25
Hajjar, Ihab; Marmerelis, Vasilis; Shin, Dae C et al. (2014) Assessment of cerebrovascular reactivity during resting state breathing and its correlation with cognitive function in hypertension. Cerebrovasc Dis 38:10-6
Hajjar, Ihab; Rodgers, Kathleen (2013) Do angiotensin receptor blockers prevent Alzheimer's disease? Curr Opin Cardiol 28:417-25
Hajjar, Ihab; Hart, Meaghan; Wan, Siu-Hin et al. (2013) Safety and blood pressure trajectory of short-term withdrawal of antihypertensive medications in older adults: experience from a clinical trial sample. J Am Soc Hypertens 7:289-93
Hajjar, Ihab; Hart, Meaghan; Chen, Yu-Ling et al. (2013) Antihypertensive therapy and cerebral hemodynamics in executive mild cognitive impairment: results of a pilot randomized clinical trial. J Am Geriatr Soc 61:194-201
Hajjar, Ihab; Hart, Meaghan; Chen, Yu-Ling et al. (2012) Effect of antihypertensive therapy on cognitive function in early executive cognitive impairment: a double-blind randomized clinical trial. Arch Intern Med 172:442-4
Hajjar, Ihab; Brown, Lauren; Mack, Wendy J et al. (2012) Impact of Angiotensin receptor blockers on Alzheimer disease neuropathology in a large brain autopsy series. Arch Neurol 69:1632-8
Hajjar, Ihab; Quach, Lien; Yang, Frances et al. (2011) Hypertension, white matter hyperintensities, and concurrent impairments in mobility, cognition, and mood: the Cardiovascular Health Study. Circulation 123:858-65
Kim, Dae Hyun; Newman, Anne B; Hajjar, Ihab et al. (2011) Retinal microvascular signs and functional loss in older persons: the cardiovascular health study. Stroke 42:1589-95

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