Influence of Age, Weight and Ethnic Background on Blood Pressure

NCT ID: NCT03014791

Last Updated: 2022-08-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-02-21

Study Completion Date

2024-02-29

Brief Summary

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Hypertension, also known as high blood pressure, is a chronic medical condition, in which the blood pressure is elevated. This is a common condition, which can lead to severe complications such as cardiovascular disease, heart attack, stroke and kidney disease, if not detected and treated early.

Accumulating evidence suggests that the incidence of hypertension varies according to age, ethnicity and obesity. In order to obtain an in-depth knowledge of the pathophysiological mechanisms of hypertension, we aim to investigate the haemodynamic and biochemical correlates of elevated blood pressure across the adult age-span, and determine the extent to which body size and ethnicity impact on these associations. We also wish to investigate the impact of hypertension on key target organs (end-organ damage). The primary objective of this study is to compare the mechanisms regulating blood pressure in hypertensive and non-hypertensive participants across the adult age span, and to assess the influence of body mass index and ethnic background on these mechanisms. Secondary objectives are to investigate the association between blood pressure and cardiovascular physiology across the adult age span at rest and during sub-maximal exercise and to investigate the impact of blood pressure haemodynamics on key organs including the arteries and heart by assessing end-organ damage such as endothelial function, arterial structure and left ventricular mass/function.

This study will be a combined case-control and cross-sectional study describing the procedures and time commitment required to investigate our scientific aims. This is a single centre study that will be conducted in a secondary care environment. Both male and females aged 18 and over and that are able provide informed consent will be considered for this study. People who are pregnant, currently receiving dialysis, illness with a life expectancy \<1 year, current active malignancy and cannot provide informed consent are ineligible for this study. The study will be open for five years and each patient will complete a maximum of four visits in a 12 month period. Participants will complete a variety of non-invasive physiological assessments of their cardiovascular system and lung function. There will be some minimally invasive procedures completed, including a blood test and assessment of small artery endothelial function which involves insertion of a small needle under local anesthetic.

Detailed Description

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Conditions

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Cardiovascular Diseases Vascular Diseases Hypertension

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Healthy Volunteers

No IMP to be administered, only challenge agents as part of the physiological assessments.

Large artery endothelial function:

* Glyceryl trinitrate 500 μg (Sublingual administration to stimulate endothelium-independent vasodilatation)
* Salbutamol 2 x 200 μg (Administered by spacer device to stimulate endothelium-dependent vasodilatation)

Forearm blood flow

* Acetylcholine: 7.5μg/min, 15μg/min and 30μg/min (Intra-arterial administration via brachial artery to stimulate endothelium-dependent vasodilatation)
* Sodium nitroprusside: 3μg/min, 10μg/min (Intra-arterial administration via brachial artery to stimulate endothelium-independent vasodilatation)
* LNMMA: 2μmol/min, 4μmol/min (Intra-arterial administration via brachial artery to block basal nitric oxide production)

Brief lifestyle/medical history questionnaire

Intervention Type OTHER

Core Measurement

Anthropometric measures

Intervention Type OTHER

Core Measurement

Blood pressure and arterial stiffness

Intervention Type OTHER

Core Measurement

Cardiac output and lung function

Intervention Type OTHER

Core Measurement

Heart rate variability

Intervention Type OTHER

Core Measurement

Blood sample & spot urine sample

Intervention Type OTHER

Core Measurement

24 hour ambulatory blood pressure monitor

Intervention Type OTHER

Detailed Measurement (Optional for participants).

24 hour urine collection

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Echocardiograph: Left ventricular mass

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Large artery structure: Carotid intima-media thickness

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Small artery structure: Minimum forearm vascular resistance

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Large artery endothelial function

Intervention Type OTHER

Flow- and salbutamol-mediated vasodilatation Detailed Measurement (Optional for participants).

Small artery endothelial function: Forearm blood flow

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Dundee step test

Intervention Type OTHER

Systolic blood pressure response to submaximal exercise Detailed Measurement (Optional for participants).

Detailed haemodynamic response to submaximal exercise

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Cardiopulmonary fitness: Maximum oxygen consumption

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Haemodynamic response to mental stress

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Small artery dilatory function: Forearm blood flow

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Hypertensive Patients (Case-control)

No IMP to be administered, only challenge agents as part of the physiological assessments.

Large artery endothelial function:

* Glyceryl trinitrate 500 μg (Sublingual administration to stimulate endothelium-independent vasodilatation)
* Salbutamol 2 x 200 μg (Administered by spacer device to stimulate endothelium-dependent vasodilatation)

Forearm blood flow

* Acetylcholine: 7.5μg/min, 15μg/min (Intra-arterial administration via brachial artery to stimulate endothelium-dependent vasodilatation)
* Sodium nitroprusside: 3μg/min, 10μg/min (Intra-arterial administration via brachial artery to stimulate endothelium-independent vasodilatation)
* LNMMA: 2μmol/min, 4μmol/min (Intra-arterial administration via brachial artery to block basal nitric oxide production)

Brief lifestyle/medical history questionnaire

Intervention Type OTHER

Core Measurement

Anthropometric measures

Intervention Type OTHER

Core Measurement

Blood pressure and arterial stiffness

Intervention Type OTHER

Core Measurement

Cardiac output and lung function

Intervention Type OTHER

Core Measurement

Heart rate variability

Intervention Type OTHER

Core Measurement

Blood sample & spot urine sample

Intervention Type OTHER

Core Measurement

24 hour ambulatory blood pressure monitor

Intervention Type OTHER

Detailed Measurement (Optional for participants).

24 hour urine collection

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Echocardiograph: Left ventricular mass

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Large artery structure: Carotid intima-media thickness

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Small artery structure: Minimum forearm vascular resistance

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Large artery endothelial function

Intervention Type OTHER

Flow- and salbutamol-mediated vasodilatation Detailed Measurement (Optional for participants).

Small artery endothelial function: Forearm blood flow

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Dundee step test

Intervention Type OTHER

Systolic blood pressure response to submaximal exercise Detailed Measurement (Optional for participants).

Detailed haemodynamic response to submaximal exercise

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Cardiopulmonary fitness: Maximum oxygen consumption

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Haemodynamic response to mental stress

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Small artery dilatory function: Forearm blood flow

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Hypertensive Patients (Cross-sectional)

No IMP to be administered, only challenge agents as part of the physiological assessments.

Large artery endothelial function:

Same challenge agents as healthy volunteer and hypertensive patient (Case-control) arms

Forearm blood flow Same challenge agents as healthy volunteer and hypertensive patient (Case-control) arms

Recruited from community-based cohort studies - CLEAREST and ACCT

Equal recruitment across the following parameters:

* Age: 3 groups \<30, 30-60, \>60 years
* Gender
* BMI: 3 groups \<25, 25-30, \>30 Kg/m2

Brief lifestyle/medical history questionnaire

Intervention Type OTHER

Core Measurement

Anthropometric measures

Intervention Type OTHER

Core Measurement

Blood pressure and arterial stiffness

Intervention Type OTHER

Core Measurement

Cardiac output and lung function

Intervention Type OTHER

Core Measurement

Heart rate variability

Intervention Type OTHER

Core Measurement

Blood sample & spot urine sample

Intervention Type OTHER

Core Measurement

24 hour ambulatory blood pressure monitor

Intervention Type OTHER

Detailed Measurement (Optional for participants).

24 hour urine collection

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Echocardiograph: Left ventricular mass

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Large artery structure: Carotid intima-media thickness

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Small artery structure: Minimum forearm vascular resistance

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Large artery endothelial function

Intervention Type OTHER

Flow- and salbutamol-mediated vasodilatation Detailed Measurement (Optional for participants).

Small artery endothelial function: Forearm blood flow

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Dundee step test

Intervention Type OTHER

Systolic blood pressure response to submaximal exercise Detailed Measurement (Optional for participants).

Detailed haemodynamic response to submaximal exercise

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Cardiopulmonary fitness: Maximum oxygen consumption

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Haemodynamic response to mental stress

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Small artery dilatory function: Forearm blood flow

Intervention Type OTHER

Detailed Measurement (Optional for participants).

Interventions

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Brief lifestyle/medical history questionnaire

Core Measurement

Intervention Type OTHER

Anthropometric measures

Core Measurement

Intervention Type OTHER

Blood pressure and arterial stiffness

Core Measurement

Intervention Type OTHER

Cardiac output and lung function

Core Measurement

Intervention Type OTHER

Heart rate variability

Core Measurement

Intervention Type OTHER

Blood sample & spot urine sample

Core Measurement

Intervention Type OTHER

24 hour ambulatory blood pressure monitor

Detailed Measurement (Optional for participants).

Intervention Type OTHER

24 hour urine collection

Detailed Measurement (Optional for participants).

Intervention Type OTHER

Echocardiograph: Left ventricular mass

Detailed Measurement (Optional for participants).

Intervention Type OTHER

Large artery structure: Carotid intima-media thickness

Detailed Measurement (Optional for participants).

Intervention Type OTHER

Small artery structure: Minimum forearm vascular resistance

Detailed Measurement (Optional for participants).

Intervention Type OTHER

Large artery endothelial function

Flow- and salbutamol-mediated vasodilatation Detailed Measurement (Optional for participants).

Intervention Type OTHER

Small artery endothelial function: Forearm blood flow

Detailed Measurement (Optional for participants).

Intervention Type OTHER

Dundee step test

Systolic blood pressure response to submaximal exercise Detailed Measurement (Optional for participants).

Intervention Type OTHER

Detailed haemodynamic response to submaximal exercise

Detailed Measurement (Optional for participants).

Intervention Type OTHER

Cardiopulmonary fitness: Maximum oxygen consumption

Detailed Measurement (Optional for participants).

Intervention Type OTHER

Haemodynamic response to mental stress

Detailed Measurement (Optional for participants).

Intervention Type OTHER

Small artery dilatory function: Forearm blood flow

Detailed Measurement (Optional for participants).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Male or Female, aged 18 or above
* Able to give informed consent and willing to participate

Exclusion Criteria

* Pregnancy
* Current active malignancy
* Currently receiving dialysis
* Any illness with a life expectancy \< 1 year
* Lack of written informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Cambridge

OTHER

Sponsor Role collaborator

Cambridge University Hospitals NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Carmel McEniery

Senior Research Associate

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Carmel McEniery, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Cambridge

Locations

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Vascular Research Clinic, Addenbrooke's Hospital

Cambridge, Cambridgeshire, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Natalie Byrne

Role: CONTACT

01223 349762

Carmel McEniery, PhD

Role: CONTACT

01223 217564

Facility Contacts

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Carmel McEniery, PhD

Role: primary

Other Identifiers

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AWE

Identifier Type: -

Identifier Source: org_study_id

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