and treated within the past two years that, in the judgment of clinical study staff, would compromise a participant’s ability to comply with the protocol and complete the trial. Exceptions to the exclusion for diagnosed cancer would include, for example, non-melanoma skin cancer, early-stage prostate cancer, localized breast cancer. 14. Any factors judged by the clinic team to be likely to limit adherence to interventions. For example, (a) Active alcohol or substance abuse within the last 12 months (b) Plans to move outside the clinic catchment area in the next 2 years without the ability to transfer to another SPRINT site, or plans to be out of the study area for more than 3 months in the year following enrollment. (c) Significant history of poor compliance with medications or attendance at clinic visits (d) Significant concerns about participation in the study from spouse, significant other, or family members (e) Lack of support from primary health care provider Version 4.0 18 November 1, 2012 (f) Residence too far from the study clinic site such that transportation is a barrier including persons who require transportation assistance provided by the SPRINT clinic funds for screening or randomization visits (g) Residence in a nursing home. Persons residing in an assisted living or retirement community are eligible if they meet the other criteria. (h) Clinical diagnosis of dementia, treatment with medications for dementia, or in the judgment of the clinician cognitively unable to follow the protocol (i) Other medical, psychiatric, or behavioral factors that in the judgment of the Principal Investigator may interfere with study participation or the ability to follow the intervention protocol 15. Failure to obtain informed consent from participant 16. Currently participating in another clinical trial (intervention study). Note: Patient must wait until the completion of his/her activities or the completion of the other trial before being screened for SPRINT. 17. Living in the same household as an already randomized SPRINT participant 18. Any organ transplant 19. Unintentional weight loss > 10% in last 6 months 20. Pregnancy, currently trying to become pregnant, or of child-bearing potential and not using birth control c) Additional Criteria I. SENIOR Whereas there are no eligibility criteria specific to the SENIOR subgroup other than age, the general eligibility criteria were influenced by consideration of factors of importance to the inclusion of older participants in SPRINT, including cognitive status, orthostasis, transportation, and site of residence (e.g., nursing home). The goal is to assemble a representative population of older patients for whom intensive BP lowering is reasonable to consider from a medical perspective. This goal is motivated by the perspective that there may be some older persons with advanced frailty and/or multiple comorbid conditions whose health is so poor that it would not be reasonable to attempt to treat SBP as intensively as needed to control SBP to less than 120 mm Hg. II. Participants with CKD For the purposes of SPRINT, qualifying CKD is defined by eGFR, determined during the 6 months prior to randomization, between 20 and 59 ml/min/1.73m2 , inclusive, based on the 4-variable MDRD equation. Patients with significant proteinuria, defined as a 24- hour urine protein excretion exceeding 1 gram, or rough equivalents thereof (see Exclusion Criterion 4 above), will be excluded from SPRINT based on evidence from previous trials suggesting that intensive BP lowering therapy may be beneficial with respect to slowing the progression of CKD. The vast majority of participants with CKD so defined will likely be at high risk for CVD. An estimated 82.3% of those who qualify with eGFR between 45 and 59 ml/min/1.73m2 will have a Framingham Risk Score for CVD exceeding 15% over 10 years, and an estimated 71.2% have a Framingham Risk Score for CVD exceeding 20% over 10 years; hence, these participants will contribute substantially to the overall event rate and provide the basis for informative subgroup analyses. III. MIND Version 4.0 19 November 1, 2012 Dementia Screening - All individuals will receive dementia screening at baseline and every 2 years following baseline. Individuals who have been previously diagnosed with dementia by their physicians are excluded from SPRINT and SPRINT MIND. Comprehensive Cognitive Assessment substudy – A subset of 2800 participants enrolled in SPRINT will also be assigned to undergo more extensive cognitive assessment to evaluate the impact of the intervention on decline in overall and domainspecific cognitive function that does not meet criteria for dementia. With limited exceptions, all clinics will enroll participants into this 2800 subset, and this subgroup is expected to be representative of all randomized participants, including the important CKD and SENIOR participants. IV. MIND MRI Individuals who enroll in the Comprehensive Cognitive Assessment substudy at a clinic within sufficient proximity to a SPRINT MIND MRI center, generally defined as within a 2 to 3 hour driving radius, are eligible to enroll in the MIND MRI Study. The MIND MRI Study will have a recruitment goal of approximately 640 participants. Standard safetyrelated exclusions pertaining to the ability to have a magnetic resonance imaging procedure performed will be applied. Recruitment and risk