Cardiovascular Longitudinal ALSPAC Research Investigations Following Hypertensive Pregnancy in Young Adulthood
- Conditions
- Cardiovascular DiseasesHypertensionCerebrovascular DiseasesVascular DiseasesHypertension in PregnancyYoung Adult
- Registration Number
- NCT05683093
- Lead Sponsor
- University of Oxford
- Brief Summary
The purpose of this study is to understand more about why young people who were born to a hypertensive pregnancy may have increased risk of high blood pressure and are often at increased risk of heart and blood vessel disease later in life.
- Detailed Description
Women who develop blood pressure problems during pregnancy are more likely to have high blood pressure (hypertension) in later life as well as heart attacks or strokes. The children born to the pregnancy also tend to have higher blood pressure and are often at increased risk of heart and blood vessel disease later in life. Previous work has shown that children born to pregnancies where the mother has high blood pressure have changes in their blood vessels, heart and brain that can be measured long before they develop high blood pressure or other clinical symptoms. By understanding the pattern of changes cross multiple parts of the body, over a lifetime, the investigators can identify how advanced the underlying disease is for an individual and how their disease is likely to develop over the next few years.
The aim of this study is to understand the heart and blood vessel changes of people born to a hypertensive pregnancy once they are in their 20s and 30s. The investigators then hope to use this information to develop new ways to prevent early onset heart and blood vessel disease in these people.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 200
- Participant is willing and able to give informed consent for participation in the study
- Male or female, aged 30 to 40 years at time of enrolment
- Participant previously took part in the ALSPAC study
- Able (in the investigator's opinion) and willing to comply with all study requirements
- Adequate understanding of verbal and written English
- Pregnant or lactating when they are due to attend for study visit 1
- Less than six months postpartum
- Planning to donate blood within two weeks prior to study visit 1
- Any significant disease or disorder which, in the opinion of the investigator, might influence the participant's ability to participate in the study
- Evidence of congenital heart disease or significant chronic disease relevant to cardiovascular or metabolic status
For exclusion of MRI component only:
- Unsuitable for MRI based on participant screening; the participant may still be included in other parts of the study
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Cardiac right ventricular mass 30-40 years of old Magnetic resonance imaging (MRI) assessment of cardiac right ventricular mass indexed to body surface area (in g and g/m\^2)
- Secondary Outcome Measures
Name Time Method Waist-to-hip ratio 30-40 years of old The ratio of waist circumference (in cm) to hip circumference (in cm)
Diastolic blood pressure 30-40 years of old Resting brachial blood pressure measurement (in mmHg)
Pulse pressure 30-40 years of old The difference between systolic and diastolic blood pressure (in mmHg)
Cardiac right ventricular end-diastolic volume 30-40 years of old MRI assessment of cardiac right ventricular end-diastolic volume indexed to body surface area (in ml and ml/m\^2)
Cardiac left ventricular systolic function 30-40 years of old Echocardiography and MRI assessment of left ventricular systolic function: left ventricular ejection fraction (in %)
Renal function 30-40 years of old MRI assessment of fibro-inflammatory status from T1 (in ms) and surrogate measure of blood perfusion from T2\* (in ms) and volumes (in ml and ml/m\^2)
Carbon dioxide exchange kinetics across sub-maximal and peak exercise 30-40 years of old Cardiopulmonary exercise test to measure respiratory exchange ratio (RER calculated as carbon dioxide production divided by oxygen consumption)
Objective measure of physical activity 30-40 years of old The amount of moderate to vigorous physical activity (in h/week) and vigorous physical activity (in h/week) measured using wrist worn accelerometer
Insulin resistance index (HOMA-IR) as a metabolic marker 30-40 years of old The index calculated as fasting glucose (in mmol/L) x fasting insulin (in μIU/mL) ÷ 22.5
Circulating soluble intercellular adhesion molecule-1 (sICAM-1) as an inflammatory marker 30-40 years of old The level of sICAM-1 (in ng/mL) measured from serum blood samples
Mid-arm circumference 30-40 years of old Mid-arm circumference measured in cm
Aortic compliance 30-40 years of old Aortic distensibility by MRI (in 10\^-3 mmHg\^-1) and aortic/central blood pressure by cuff measurement (in mmHg)
Retinal venular structure 30-40 years of old Central retinal venular equivalent (CRVE in μm) measured using retinal imaging
White matter hyperintensities volume 30-40 years of old Total volume of white matter hyperintensities (in mm3) assessed on T2-weighted sequence of brain MRI
Circulating soluble fms-like tyrosine kinase-1 (sFlt-1) as an antiangiogenic marker 30-40 years of old The level of sFlt-1 (in pg/mL) measured from plasma blood samples
Circulating fasting insulin concentration as a metabolic marker 30-40 years of old The level of fasting insulin (in pmol/L) measured from serum blood samples
Circulating soluble vascular cell adhesion molecule-1 (sVCAM-1) as an inflammatory marker 30-40 years of old The level of sVCAM-1 (in ng/mL) measured from serum blood samples
Body weight 30-40 years of old Body weight measured in kg
Cardiac right ventricular stroke volume 30-40 years of old MRI assessment of cardiac right ventricular stroke volume indexed to body surface area (in ml and ml/m\^2)
Cardiac left ventricular stroke volume 30-40 years of old MRI assessment of cardiac left ventricular stroke volume indexed to body surface area (in ml and ml/m\^2)
Cardiac right ventricular systolic function 30-40 years of old Echocardiography and MRI assessment of right ventricular systolic function: tricuspid annular plane systolic excursion (in cm) and right ventricular ejection fraction measured by cardiac MRI (in %)
Cardiac right ventricular diastolic function 30-40 years of old Echocardiography assessment of right ventricular (RV) diastolic function: RV Doppler early/late diastolic tricuspid inflow velocity ratio (E/A)
Morphology of the right ventricles 30-40 years of old MRI assessment of the right ventricles morphology using cardiac statistical atlas and principal component analysis
Total grey matter volume 30-40 years of old Total grey matter volumes (in mm3) assessed on T1-weighted sequence of brain MRI
Subcortical brain volume of thalamus 30-40 years of old Subcortical brain volume of thalamus (in mm3) assessed on T1-weighted sequence of brain MRI
Cerebral vessel lumen diameter 30-40 years of old Cerebral vessel lumen diameter (in μm) assessed on the time-of-flight sequence of brain MRI
Arterial cerebral blood volume fraction 30-40 years of old Arterial cerebral blood volume fraction (in %) assessed on arterial spin labelling of brain MRI
Circulating total cholesterol as a metabolic marker 30-40 years of old The level of total cholesterol (in mmol/L) measured from serum blood samples
Circulating high-density lipoprotein as a metabolic marker 30-40 years of old The level of HDL (in mmol/L) measured from serum blood samples
Circulating triglycerides as a metabolic marker 30-40 years of old The level of triglycerides (in mmol/L) measured from serum blood samples
Circulating fasting glucose concentration as a metabolic marker 30-40 years of old The level of fasting glucose (in mmol/L) measured from whole blood samples
Circulating C-reactive protein (CRP) as an inflammatory marker 30-40 years of old The level of CRP (in mmol/L) measured from serum blood samples
Body mass index 30-40 years of old Body weight divided by the square of height (in kg/m2)
Systolic blood pressure 30-40 years of old Resting brachial blood pressure measurement (in mmHg)
Heart rate 30-40 years of old The frequency of the heart contractions per minute (in beats per minute or bpm)
Morphology of the left ventricles 30-40 years of old MRI assessment of the left ventricles morphology using cardiac statistical atlas and principal component analysis
Intra-hepatic lipid content, steatohepatitis and hepatic fibrosis 30-40 years of old MRI assessment of the liver to quantify proton density fat fraction (in %) and fibro-inflammatory status from iron-corrected T1 (cT1 in ms)
Total white matter volume 30-40 years of old Total white matter volumes (in mm3) assessed on T1-weighted sequence of brain MRI
Cerebral vessel tortuosity 30-40 years of old The ratio of cerebral vessel tortuosity assessed on the time-of-flight sequence of brain MRI
Whole brain grey matter perfusion or cerebral blood flow (CBF) 30-40 years of old Whole brain grey matter perfusion/CBF (in ml/100g/min) assessed on arterial spin labelling of brain MRI
Body height 30-40 years of old Body height measured in m
Smoking status 30-40 years of old The number and percentage of current smokers
Alcohol consumption 30-40 years of old Weekly alcoholic unit intake (in units per week)
Cerebral vessel density 30-40 years of old Cerebral vessel density (in mm3) assessed on the time-of-flight sequence of brain MRI
Cardiac left ventricular mass 30-40 years of old MRI assessment of cardiac left ventricular mass indexed to body surface area (in g and g/m\^2)
Cardiac left ventricular end-diastolic volume 30-40 years of old MRI assessment of cardiac left ventricular end-diastolic volume indexed to body surface area (in ml and ml/m\^2)
Cardiac left ventricular diastolic function 30-40 years of old Echocardiography assessment of left ventricular (LV) diastolic function: LV Doppler early/late diastolic mitral inflow velocity ratio (E/A) and LV early Doppler inflow velocity/peak early diastolic tissue velocity ratio (E/e')
Oxygen uptake across sub-maximal and peak exercise 30-40 years of old Cardiopulmonary exercise test to measure oxygen uptake (VO2 in ml/kg/min)
Retinal arteriolar structure 30-40 years of old Central retinal arteriolar equivalent (CRAE in μm) measured using retinal imaging
Retinal arteriolar-to-venular diameter ratio (AVR) 30-40 years of old The ratio of average retinal arteriolar diameter (CRAE in μm) and average retinal venous diameter (CRVE in μm) measured using retinal imaging
Ear microvascular structure 30-40 years of old Superior crus of anti-helix earlobe vascular caliber (in μm) measured using ear vascular imaging
Lung function 30-40 years of old The forced expiratory volume in one second (FEV1 in L), forced vital capacity (FVC in L), and the ratio of FEV1 to FVC (FEV1/FVC) measured using spirometry
Subcortical brain volume of hippocampus 30-40 years of old Subcortical brain volume of hippocampus (in mm3) assessed on T1-weighted sequence of brain MRI
White matter hyperintensities count 30-40 years of old The number of white matter hyperintensities on T2-weighted sequence of brain MRI
Circulating vascular endothelial growth factor A (VEGF-A) as an angiogenic marker 30-40 years of old The level of VEGF-A (in pg/mL) measured from plasma blood samples
Circulating soluble endoglin (sENG) as an angiogenic marker 30-40 years of old The level of sENG (in ng/mL) measured from plasma blood samples
Circulating low-density lipoprotein as a metabolic marker 30-40 years of old The level of LDL (in mmol/L) measured from serum blood samples
Mean arterial pressure 30-40 years of old The average arterial pressure from resting brachial blood pressure measurement (in mmHg)
Trial Locations
- Locations (1)
University of Oxford
🇬🇧Oxford, Oxfordshire, United Kingdom