The major objectives of the SPRINT initiative are to: 1. determine whether treating SBP to a lower goal than currently recommended wil reduce CVD;2. determine, in the stage 3 CKD subgroup, whether the intensive intervention wil reduce CVD and reduce the progression of renal disease;3. determine the relative impact of the 2 treatment strategies on quality of life;4. compare the relative cost effectiveness of the 2 treatment strategies;5. determine whether the intensive intervention wil reduce the rate of age-related cognitive impairment;6. determine, in a subset, whether the intensive intervention wil reduce the rate of age-related cognitive impairment ($PRINT~MIND). A second objective is to perform MRI imaging on a subset of the 2,800 participants in the SPRINT-MIND substudy. A third objective is to screen all 7,500 SPRINT participants annually in order to diagnose probable dementia (SPRINT-MIND);and 7. perform DNA extraction and analysis for investigation of relevant pathway genes, genome-wide association, and sequencing in order to define the full spectrum of variants functionally responsible for differences in hypertension risk and related events due to relative levels of BP control. The major objectives of the SPRINT-MIND Substudy are as follows: 1. Cognitive functioning: To determine whether the intensive intervention wil reduce the incidence of cognitive decline and incidence of probable dementia;2. Imaging: To determine whether the intensive intervention wil reduce the incidence of structural central nervous system abnormalities related to vascular dementia, and rate of decline in total brain volume;and 3. Diagnosis of probable dementia: To screen all 7,500 participants annually for probable dementia. The objective of this proposal is to create a clinical network to recruit 1,700 SPRINT participants.
