China Antihypertensive Trial for Intracranial Aneurysm

Inclusion criteria

• Age 18-75.
• Chinese ethnicity.
• Unruptured saccular intracranial aneurysm (UIA) identified by computational tomography angiography, magnetic resonance angiography or digital subtraction angiography.

• Maximal size of UIA at largest dimension < 7 mm
• The morphology of UIA is regular (no bleb(s) or secondary aneurysm(s) protruding from the UIA fundus or bi-/ multi-lobular UIA fundus)
• UIA receiving conservative treatment
• History of primary hypertension (as diagnosed per standard of care)
• Systolic blood pressure (SBP) on 2 consecutive visits:

SBP: 130-180 mmHg on 0 or 1 antihypertensive medication. SBP: 130-170 mmHg on up to 2 antihypertensive medications. SBP: 130-160 mmHg on up to 3 antihypertensive medications. SBP: 130-150 mmHg on up to 4 antihypertensive medications

• Good medication adherence (Morisky Medication Adherence Scale ≥6)
• Obtain informed consent from patient or legal representative

Exclusion criteria

• Patients with neurological symptom related to UIA, such as sentinel headache, oculomotor paralysis and so on.
• Patients with additional active intracranial disease including vasculopathy, arteriovenous malformation/fistula, cancer, traumatic brain injury etc.
• Patients with fusiform, dissecting, blister, traumatic, mycotic/ bacterial, myxomatous, and tumor-associated UIAs are excluded.
• Patients with history of polycystic kidney disease, rheumatic disease or autoimmune disease.
• Patients with family history of intracranial aneurysm (defined when two direct relatives of patients within three generations have intracranial aneurysms or aneurysmal subarachnoid hemorrhage).
• Patients with known secondary cause of hypertension.
• Patients with myocardial infarction, ischemic stroke, symptomatic heart failure during the past 3 months.
• Patients with a medical condition likely to limit survival to less than 2 years.
• Patients during pregnancy and perinatal period.
• Any concurrent serious illness that would interfere with the outcome assessments including hepatic, renal, gastroenterological, respiratory, cardiovascular, endocrinologic, immunologic, and hematologic disease.
• Inability or unwillingness of patient or legal representative to give written informed consent.
• Participation in a concurrent interventional medical investigation or clinical trial.