Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The purpose of this study is to understand more about why women who have had hypertensive pregnancies may be at increased risk of high blood pressure and why these women are often at increased risk of heart and blood vessel disease later in life.
Women who experience high blood pressure during pregnancy are at increased risk of developing cardiac and vascular diseases later in life. They show changes in their heart, brain, and blood vessels long before they develop high blood pressure. The investigators therefore think that these changes develop slowly over the course of the life of the woman and establish their risk of later disease.
Through better understanding of the pattern of changes across multiple parts of the body over extended periods of time, the investigators aim to identify how advanced the underlying disease is for an individual and how the disease is likely to develop over the next few years. By comparing the rate of change across different parts of the body, the investigators can examine how one area affects another.
Data including images of the heart, brain and blood vessels will be acquired in women 10 to 25 years after their pregnancy. The initial analysis will focus on assessing differences between women who have had a normotensive pregnancy and those who have had a hypertensive pregnancy, both at a single timepoint and in changes within individuals over time.
This dataset will then be used in conjunction with previously acquired data in women who have experienced a hypertensive pregnancy to find out how patterns emerge across the whole body. The investigators will subsequently combine information from different measures at the same time and use the machine learning models to learn the patterns of change that occur as a person progresses from a healthy to a diseased state.
This will allow the researchers to identify patterns of hypertensive disease development and it may open doors to better interventions and therapies tailored towards individuals.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hypertensive pregnancy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hypertensive pregnancy | Other | Participants will attend one visit lasting approximately 3-4 hours on a single day or split over multiple visits to complete all measures. Participants will first be asked to provide written informed consent for the study. Participants' anthropometric measures (waist-to-hip ratio, height and weight, hip and waist circumference and left arm circumference and resting blood pressures will then be taken. After this, the participants will undergo cardiopulmonary exercise testing, followed by magnetic resonance imaging, echocardiography, retinal imaging and vascular imaging of the ear. The study visit will conclude with participants being provided with a wrist-worn physical activity monitor to wear for 7-9 days following the visit. These monitors will provide objective measures of physical activity while people go about their normal activities. |
| Measure | Description | Time Frame |
|---|---|---|
| Cardiac right ventricular mass | Magnetic resonance imaging assessment of cardiac right ventricular mass indexed to body surface area (g/m^2). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy. Index pregnancy is defined as the pregnancy which we first collected data from. |
| Measure | Description | Time Frame |
|---|---|---|
| Cardiac left ventricular mass | Magnetic resonance imaging assessment of cardiac left ventricular mass indexed to body surface area (g/m^2). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac right ventricular end-diastolic volume |
Not provided
Inclusion Criteria:
Inclusion Criteria
Exclusion Criteria:
The participant may not enter the study if ANY of the following apply:
For exclusion of MRI component only:
• Unsuitable for MRI based on the responses to the MRI screening form. The participant may still be included in other parts of the study.
Females only.
The investigators will study a group of 200 women at 10 to 25 years postpartum to extend data coverage over time and to ensure a broad representation of hypertensive disease state during mid-life in women. This will be achieved by a follow-up of participants from a previous study called Preeclampsia Vascular Study (PVS) (08/H0604/127). These women were originally seen at 5 to 15 years post-index hypertensive or normotensive pregnancy. If required, the investigators will restart their identification and recruitment methods, previously used in PVS, based on obstetric records to identify, and recruit additional women who had pregnancies 10 to 25 years prior, to ensure that the sample size is reached. All participants will undergo a standardised imaging protocol as described in the general overview.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Katie Suriano | Contact | 01865226845 | helpful@cardiov.ox.ac.uk |
| Name | Affiliation | Role |
|---|---|---|
| Paul Leeson | University of Oxford | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Oxford Department of Cardiovascular Medicine | Recruiting | Oxford | OX3 9DU | United Kingdom |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D006973 | Hypertension |
| D002318 | Cardiovascular Diseases |
| D002561 | Cerebrovascular Disorders |
| D014652 | Vascular Diseases |
| D011225 | Pre-Eclampsia |
| D046110 | Hypertension, Pregnancy-Induced |
| D018450 | Disease Progression |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D011248 | Pregnancy Complications |
Not provided
Not provided
Not provided
Not provided
Not provided
Blood samples.
|
Magnetic resonance imaging assessment of cardiac right ventricular end-diastolic volume indexed to body surface area (ml/m^2) |
| Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac right ventricular stroke volume. | Magnetic resonance imaging assessment of cardiac right ventricular stroke volume indexed to body surface area (ml/m^2). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac left-ventricular end-diastolic volume. | Magnetic resonance imaging assessment of cardiac left ventricular end-diastolic volume indexed to body surface area (ml/m^2). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac left ventricular stroke volume | Magnetic resonance imaging assessment of cardiac left ventricular stroke volume indexed to body surface area (ml/m^2). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac right ventricular systolic function | Echocardiography assessment of right ventricular systolic function: tricuspid annular plane systolic excursion (cm). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac right ventricular ejection fraction | Magnetic resonance imaging assessment of right ventricular ejection fraction measured by cardiac magnetic resonance imaging (%). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac left ventricular systolic function | Echocardiography assessment of left ventricular systolic function | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac left ventricular ejection fraction | Magnetic resonance imaging assessment of left ventricular ejection fraction (%). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac right ventricular diastolic function | Echocardiography assessment of right ventricular doppler early/late diastolic tricuspid inflow velocity ratio (E/A) | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac left ventricular diastolic function | Echocardiography assessment of left ventricular doppler early/late diastolic mitral inflow velocity ratio (E/A). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cardiac left ventricular diastolic function | Echocardiography assessment of left ventricular early doppler inflow velocity/peak early diastolic tissue velocity rate (E/e'). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Morphology of the right ventricles | Magnetic resonance imaging assessment of the right ventricles morphology using cardiac statistical atlas and principal component analysis. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Morphology of the left ventricles | Magnetic resonance imaging assessment of the left ventricles morphology using cardiac statistical atlas and principal component analysis. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Aortic distensibility | Aortic distensibility by magnetic resonance imaging (10^-3 mmHg-1). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Aortic compliance | Aortic/central blood pressure by cuff measurement (mmHg). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Intra-hepatic liquid content and steatohepatitis | Magnetic resonance imaging assessment of the liver to quantify proton density fat fraction (%). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Hepatic fibrosis | Magnetic resonance imaging assessment of the liver to quantify fibro-inflammatory status from iron corrected T1 (cT1 in ms) | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Renal volumes | Magnetic resonance imaging assessment of renal volumes (ml/m^2). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Renal fibro-inflammatory status | Magnetic resonance imaging assessment of fibro-inflammatory status from T1 (ms) | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Renal blood perfusion | Magnetic resonance imaging assessment of surrogate measures of blood perfusion from T2* (in ms). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Oxygen uptake across submaximal exercise | Cardiopulmonary exercise test to measure oxygen uptake (ml/kg/min). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Carbon dioxide exchange kinetics across submaximal exercise | Cardiopulmonary exercise test to measure respiratory exchange ratio (RER) calculated as carbon dioxide production divided by oxygen consumption. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Retinal arteriolar structure | Central retinal arteriolar equivalent (CRAE) in micrometres measured using retinal imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Retinal venular structure | Central retinal venular equivalent (micrometres) measured using retinal imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Retinal arteriolar-to venule diameter ratio (AVR) | The ratio of average retinal arteriolar diameter and average retinal venous diameter (micrometres). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Ear microvascular structure. | Superior crus of anti-helix earlobe vascular calibre (micrometres) measured using ear vascular imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Lung function | The ratio of FEV1 to FVC (FEV1/FVC) measured using spirometry. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Lung capacity | The forced vital capacity (FVC in L) measured using spirometry. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Lung volume | The forced expiratory volume in one second (FEV1 in L) measured using spirometry. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Objective measure of vigorous physical activity. | The amount of vigorous physical activity (h/week) measured using wrist worn accelerometer. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Objective measure of moderate to vigorous physical activity. | The amount of moderate to vigorous physical activity (h/week) measured using wrist worn accelerometer. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Total white matter volume | Total white matter volumes (mm3) assessed on T1-weighted sequence of brain magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Total grey matter volume | Total grey matter volumes (mm3) assessed on T1-weighted sequence of brain magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Subcortical brain volume of thalamus | Subcortical brain volume of thalamus (mm3) assessed on T1-weighted sequence of brain magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Subcortical brain volume of hippocampus | Subcortical brain volume of hippocampus (mm3) assessed on T1-weighted sequence of brain magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| White matter hyperintensities volume | Total volume of white matter hyperintensities (mm3) assessed on T2-weighted sequence of brain magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| White matter hyperintensities count | Total number of white matter hyperintensities on T2-weighted sequence of brain magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cerebral vessel lumen diameter | Cerebral vessel lumen diameter (micrometres) assessed on the time-of-flight sequence of brain magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cerebral vessel tortuosity | The ratio of cerebral vessel tortuosity assessed on the time-of-flight sequence of brain magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Cerebral vessel density | Cerebral vessel density (mm3) assessed on the time-of-flight sequence of brain magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| 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 magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Arterial cerebral blood volume fraction | Arterial cerebral blood volume fraction (%) assessed on arterial spin labelling on brain magnetic resonance imaging. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating vascular endothelial growth factor A as an angiogenic marker | The level of circulating vascular endothelial growth factor A (pg/mL) measured from plasma blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating soluble endoglin as an angiogenic marker. | The level of circulating soluble endoglin (ng/mL) measured from plasma blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating soluble fms-like tyrosine kinase-1 as an angiogenic marker. | The level of circulating soluble fms-like tyrosine kinase-1 measured from plasma blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating total cholesterol as a metabolic marker | The level of total cholesterol (mmol/L) measured from serum blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating high-density lipoprotein as a metabolic marker | The level of circulating high-density lipoprotein (mmol/L) measured from serum blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating low-density lipoprotein as a metabolic marker | The level of circulating low-density lipoprotein (mmol/L) measured from serum blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating triglycerides as a metabolic marker | The level of circulating triglycerides (mmol/L) measured from serum blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating fasting glucose concentration as a metabolic marker | The level of fasting glucose (mmol/L) measured from whole blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating fasting insulin concentration as a metabolic marker | The level of fasting insulin (pmol/L) measured from serum blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Insulin resistance index as a metabolic marker | The index calculated as fasting glucose (mmol/L) x fasting insulin (ulU/mL)/22.5. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating C-reactive protein as an inflammatory marker. | The level of circulating C-reactive protein (mmol/L) measured from serum blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating soluble intercellular adhesion molecule-1 (slCAM-1) as an inflammatory marker | The level of sICAM-1 (ng/mL) measured from serum blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Circulating soluble vascular adhesion molecule-1 (sVCAM-1) as an inflammatory marker | The level of sVCAM-1 (ng/mL) measured from serum blood samples. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Body weight | Body weight (kg) | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Body height | Body height (m). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Body mass index (BMI) | Body weight divided by the square of height (kg/m2). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Mid-arm circumference | Mid-arm circumference (cm). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Waist-to-hip ratio | The ratio of waist circumference (cm) to hip circumference (cm). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Systolic blood pressure | Resting brachial blood pressure measurement (mmHg). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Diastolic blood pressure | Resting brachial blood pressure measurement (mmHg). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Mean arterial pressure. | The average arterial pressure from resting brachial blood pressure measurement (mmHg). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Pulse pressure | The difference between systolic and diastolic blood pressure (mmHg). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Heart rate | The frequency of the heart contractions per minute (bpm). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Smoking status | The number and percentage of current smokers. | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| Alcohol consumption | Weekly alcoholic unit intake (units per week). | Participants will be recruited at 10 to 25 years post index pregnancy and assessed up to 40 years post index pregnancy |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |