HY CYP Version 1

• Research type

  Research Study

• Full title

  Haemodynamic determinants of hYpertension in Children and Young People and role of the sympathetic nervous system: HY CYP

• IRAS ID

  306122

• Contact name

  Manish Sinha

• Contact email

  manish.sinha@gstt.nhs.uk

• Sponsor organisation

  Kings College London

• Duration of Study in the UK

  3 years, 0 months, 1 days

• Research summary

  High blood pressure (hypertension) can be caused either by the heart beating harder and faster to push blood around the body (increased cardiac output) or by a high resistance to blood flow in small blood vessels that carry the blood (increased total peripheral resistance). Studies in older people suggest that hypertension is caused mainly by the resistance of small blood vessels to blood flow, understood to be a consequence of these blood vessels becoming stiffer as they age. However, ageing processes do not explain hypertension in children and young adults and our preliminary work suggests that in contrast, the main problem in younger patients is the heart beating harder and faster. We hypothesise that this is due to overactivity of the sympathetic nervous system (the "fight or flight response") in these hypertensive young people.
  This study aims to test this theory using two separate studies. All participants (50 hypertensive and 50 controls aged 10-35) will undergo Study 1: taking detailed measurements of blood flow in the heart and large arteries (haemodynamics) using cardiac MRI and echocardiography, including during a slow breathing exercise. A subgroup of 20 hypertensive patients will undergo Study 2: lowering the blood pressure using two different medications and measuring the change in blood flow in the heart and large arteries after each medication. Hypertensive participants between 10 and 35 years will be compared to healthy controls. The results will help us distinguish whether increased cardiac output or increased total peripheral resistance is contributing to hypertension in young people and whether there are markers of increased sympathetic nervous system activity in these patients compared to controls.

• REC name

  West Midlands - South Birmingham Research Ethics Committee

• REC reference

  23/WM/0122

• Date of REC Opinion

  27 Jun 2023

• REC opinion

  Further Information Favourable Opinion