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Young AdultCLARITYNCT05683093

Cardiovascular Longitudinal ALSPAC Research Investigations Following Hypertensive Pregnancy in Young Adulthood

An observational study of Young Adult and Hypertension in Pregnancy, run by University of Oxford at 1 site in United Kingdom.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial 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. Read more about this study

Who is it for?
Ages 30 to 40 years
What is being tested?
History of being born to hypertensive or normal pregnancy
How many people
200 participants
Where
1 siteUnited Kingdom
Study dates
17 Nov 2022to 31 Jan 2027
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 30 to 40 years
  • All sexes
  • No healthy volunteers
  • Adult

Study population: Of the 200 young adults followed up from the ALSPAC study, 100 will have been born to a hypertensive pregnancy and 100 following an uncomplicated pregnancy. At time of follow-up, they will be 30 to 40 years of age. At the 25-year follow-up in Bristol, there were 610 individuals born to hypertensive pregnancies.

Who may be able to join

  • 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

Who cannot join

  • 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

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United Kingdom1 site, 1 recruiting
  • University of Oxford

    Oxford, Oxfordshire, OX3 9DU

    Katie Suriano, 01865 226845, clarity@cardiov.ox.ac.uk

    Recruiting

Other trials in United Kingdom

About this study

Official title: Cardiovascular Longitudinal the Avon Longitudinal Study of Parents and Children (ALSPAC) Research Investigations Following Hypertensive Pregnancy in Young Adulthood

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.

Read the 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.

Being tested
History of being born to hypertensive or normal pregnancy
Keywords
Young Adult, Birth History, Hypertension in Pregnancy, Cardiovascular Risk, Exercise Capacity
Medical subject headings
Hypertension, Pregnancy-Induced, Hypertension, Cardiovascular Diseases, Cerebrovascular Disorders, Vascular Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • History of being born to hypertensive or normal pregnancyOther

    CLARITY is an observational study whereby participants will attend one 4-hr visit the Division of Cardiovascular Medicine, University of Oxford at the John Radcliffe Hospital in Oxford, with the option to split the study visit over two days for convenience.

    Participants will be invited by the ALSPAC study team to attend a study visit in Oxford where the investigators will use MRI and other imaging modalities to study the brain, heart, liver, kidneys, and vasculature using standardised protocols. A dataset including information from previous follow-up of these cohorts and the detailed pregnancy data available within ALSPAC will be generated by the study team in Bristol and integrated with available data from the Oxford cohorts.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Cardiac right ventricular mass

    Magnetic resonance imaging (MRI) assessment of cardiac right ventricular mass indexed to body surface area (in g and g/m^2)

    Measured: 30-40 years of old

Secondary outcomes (58)
  1. Cardiac left ventricular mass

    MRI assessment of cardiac left ventricular mass indexed to body surface area (in g and g/m^2)

    Measured: 30-40 years of old

  2. Cardiac right ventricular end-diastolic volume

    MRI assessment of cardiac right ventricular end-diastolic volume indexed to body surface area (in ml and ml/m^2)

    Measured: 30-40 years of old

  3. Cardiac right ventricular stroke volume

    MRI assessment of cardiac right ventricular stroke volume indexed to body surface area (in ml and ml/m^2)

    Measured: 30-40 years of old

  4. Cardiac left ventricular end-diastolic volume

    MRI assessment of cardiac left ventricular end-diastolic volume indexed to body surface area (in ml and ml/m^2)

    Measured: 30-40 years of old

  5. Cardiac left ventricular stroke volume

    MRI assessment of cardiac left ventricular stroke volume indexed to body surface area (in ml and ml/m^2)

    Measured: 30-40 years of old

  6. Cardiac right ventricular systolic function

    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 %)

    Measured: 30-40 years of old

  7. Cardiac left ventricular systolic function

    Echocardiography and MRI assessment of left ventricular systolic function: left ventricular ejection fraction (in %)

    Measured: 30-40 years of old

  8. Cardiac right ventricular diastolic function

    Echocardiography assessment of right ventricular (RV) diastolic function: RV Doppler early/late diastolic tricuspid inflow velocity ratio (E/A)

    Measured: 30-40 years of old

  9. Cardiac left ventricular diastolic function

    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')

    Measured: 30-40 years of old

  10. Morphology of the right ventricles

    MRI assessment of the right ventricles morphology using cardiac statistical atlas and principal component analysis

    Measured: 30-40 years of old

  11. Morphology of the left ventricles

    MRI assessment of the left ventricles morphology using cardiac statistical atlas and principal component analysis

    Measured: 30-40 years of old

  12. Aortic compliance

    Aortic distensibility by MRI (in 10^-3 mmHg^-1) and aortic/central blood pressure by cuff measurement (in mmHg)

    Measured: 30-40 years of old

  13. Intra-hepatic lipid content, steatohepatitis and hepatic fibrosis

    MRI assessment of the liver to quantify proton density fat fraction (in %) and fibro-inflammatory status from iron-corrected T1 (cT1 in ms)

    Measured: 30-40 years of old

  14. Renal function

    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)

    Measured: 30-40 years of old

  15. Oxygen uptake across sub-maximal and peak exercise

    Cardiopulmonary exercise test to measure oxygen uptake (VO2 in ml/kg/min)

    Measured: 30-40 years of old

  16. Carbon dioxide exchange kinetics across sub-maximal and peak exercise

    Cardiopulmonary exercise test to measure respiratory exchange ratio (RER calculated as carbon dioxide production divided by oxygen consumption)

    Measured: 30-40 years of old

  17. Retinal arteriolar structure

    Central retinal arteriolar equivalent (CRAE in μm) measured using retinal imaging

    Measured: 30-40 years of old

  18. Retinal venular structure

    Central retinal venular equivalent (CRVE in μm) measured using retinal imaging

    Measured: 30-40 years of old

  19. Retinal arteriolar-to-venular diameter ratio (AVR)

    The ratio of average retinal arteriolar diameter (CRAE in μm) and average retinal venous diameter (CRVE in μm) measured using retinal imaging

    Measured: 30-40 years of old

  20. Ear microvascular structure

    Superior crus of anti-helix earlobe vascular caliber (in μm) measured using ear vascular imaging

    Measured: 30-40 years of old

  21. Lung function

    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

    Measured: 30-40 years of old

  22. Objective measure of physical activity

    The amount of moderate to vigorous physical activity (in h/week) and vigorous physical activity (in h/week) measured using wrist worn accelerometer

    Measured: 30-40 years of old

  23. Total white matter volume

    Total white matter volumes (in mm3) assessed on T1-weighted sequence of brain MRI

    Measured: 30-40 years of old

  24. Total grey matter volume

    Total grey matter volumes (in mm3) assessed on T1-weighted sequence of brain MRI

    Measured: 30-40 years of old

  25. Subcortical brain volume of thalamus

    Subcortical brain volume of thalamus (in mm3) assessed on T1-weighted sequence of brain MRI

    Measured: 30-40 years of old

  26. Subcortical brain volume of hippocampus

    Subcortical brain volume of hippocampus (in mm3) assessed on T1-weighted sequence of brain MRI

    Measured: 30-40 years of old

  27. White matter hyperintensities volume

    Total volume of white matter hyperintensities (in mm3) assessed on T2-weighted sequence of brain MRI

    Measured: 30-40 years of old

  28. White matter hyperintensities count

    The number of white matter hyperintensities on T2-weighted sequence of brain MRI

    Measured: 30-40 years of old

  29. Cerebral vessel lumen diameter

    Cerebral vessel lumen diameter (in μm) assessed on the time-of-flight sequence of brain MRI

    Measured: 30-40 years of old

  30. Cerebral vessel density

    Cerebral vessel density (in mm3) assessed on the time-of-flight sequence of brain MRI

    Measured: 30-40 years of old

  31. Cerebral vessel tortuosity

    The ratio of cerebral vessel tortuosity assessed on the time-of-flight sequence of brain MRI

    Measured: 30-40 years of old

  32. Whole brain grey matter perfusion or cerebral blood flow (CBF)

    Whole brain grey matter perfusion/CBF (in ml/100g/min) assessed on arterial spin labelling of brain MRI

    Measured: 30-40 years of old

  33. Arterial cerebral blood volume fraction

    Arterial cerebral blood volume fraction (in %) assessed on arterial spin labelling of brain MRI

    Measured: 30-40 years of old

  34. Circulating vascular endothelial growth factor A (VEGF-A) as an angiogenic marker

    The level of VEGF-A (in pg/mL) measured from plasma blood samples

    Measured: 30-40 years of old

  35. Circulating soluble endoglin (sENG) as an angiogenic marker

    The level of sENG (in ng/mL) measured from plasma blood samples

    Measured: 30-40 years of old

  36. Circulating soluble fms-like tyrosine kinase-1 (sFlt-1) as an antiangiogenic marker

    The level of sFlt-1 (in pg/mL) measured from plasma blood samples

    Measured: 30-40 years of old

  37. Circulating total cholesterol as a metabolic marker

    The level of total cholesterol (in mmol/L) measured from serum blood samples

    Measured: 30-40 years of old

  38. Circulating high-density lipoprotein as a metabolic marker

    The level of HDL (in mmol/L) measured from serum blood samples

    Measured: 30-40 years of old

  39. Circulating low-density lipoprotein as a metabolic marker

    The level of LDL (in mmol/L) measured from serum blood samples

    Measured: 30-40 years of old

  40. Circulating triglycerides as a metabolic marker

    The level of triglycerides (in mmol/L) measured from serum blood samples

    Measured: 30-40 years of old

  41. Circulating fasting glucose concentration as a metabolic marker

    The level of fasting glucose (in mmol/L) measured from whole blood samples

    Measured: 30-40 years of old

  42. Circulating fasting insulin concentration as a metabolic marker

    The level of fasting insulin (in pmol/L) measured from serum blood samples

    Measured: 30-40 years of old

  43. Insulin resistance index (HOMA-IR) as a metabolic marker

    The index calculated as fasting glucose (in mmol/L) x fasting insulin (in μIU/mL) ÷ 22.5

    Measured: 30-40 years of old

  44. Circulating C-reactive protein (CRP) as an inflammatory marker

    The level of CRP (in mmol/L) measured from serum blood samples

    Measured: 30-40 years of old

  45. Circulating soluble intercellular adhesion molecule-1 (sICAM-1) as an inflammatory marker

    The level of sICAM-1 (in ng/mL) measured from serum blood samples

    Measured: 30-40 years of old

  46. Circulating soluble vascular cell adhesion molecule-1 (sVCAM-1) as an inflammatory marker

    The level of sVCAM-1 (in ng/mL) measured from serum blood samples

    Measured: 30-40 years of old

  47. Body weight

    Body weight measured in kg

    Measured: 30-40 years of old

  48. Body height

    Body height measured in m

    Measured: 30-40 years of old

  49. Body mass index

    Body weight divided by the square of height (in kg/m2)

    Measured: 30-40 years of old

  50. Mid-arm circumference

    Mid-arm circumference measured in cm

    Measured: 30-40 years of old

  51. Waist-to-hip ratio

    The ratio of waist circumference (in cm) to hip circumference (in cm)

    Measured: 30-40 years of old

  52. Systolic blood pressure

    Resting brachial blood pressure measurement (in mmHg)

    Measured: 30-40 years of old

  53. Diastolic blood pressure

    Resting brachial blood pressure measurement (in mmHg)

    Measured: 30-40 years of old

  54. Mean arterial pressure

    The average arterial pressure from resting brachial blood pressure measurement (in mmHg)

    Measured: 30-40 years of old

  55. Pulse pressure

    The difference between systolic and diastolic blood pressure (in mmHg)

    Measured: 30-40 years of old

  56. Heart rate

    The frequency of the heart contractions per minute (in beats per minute or bpm)

    Measured: 30-40 years of old

  57. Smoking status

    The number and percentage of current smokers

    Measured: 30-40 years of old

  58. Alcohol consumption

    Weekly alcoholic unit intake (in units per week)

    Measured: 30-40 years of old

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Jan 2023
  2. Study start17 Nov 2022
  3. Primary completion1 Mar 2026 (estimated)
  4. Study completion31 Jan 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Other
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05683093
Sponsor's protocol ID
22/WA/0227
Acronym
CLARITY
Status last verified
Jan 2023
First submitted
7 Nov 2022
Last updated
12 Jan 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Young Adult and Hypertension in Pregnancy, run by University of Oxford at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 12 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Katie Suriano (01865 226845, clarity@cardiov.ox.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Cardiac right ventricular mass (time frame: 30-40 years of old). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jan 2023.

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