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The purpose of the HyperEcho study is to identify novel cardiovascular imaging phenotypes which may help in improving and personalising the management of young adults with hypertension.


HyperEcho is a multi-centre longitudinal observational study, to investigate whether baseline transthoracic echocardiography along with routine data collected in the hypertension clinic can guide clinicians to better manage, and improve risk stratification for cardiovascular disease, in young adults with hypertension.

In the UK, at least 1 in 17 adults below the age of 40 have high blood pressure. Controlling blood pressure in young adults can be a challenge for clinicians because information on the management of high blood pressure is mainly obtained from older people. To overcome this challenge, we will study clinical data, including blood pressure measurements and treatment plans in young adults, and will link them with the findings of clinical investigations (in particular the imaging scan of the heart). We hope that this study will provide us with a better understanding of how to prevent heart abnormalities and control high blood pressure in young adults.


We are conducting this study to learn more about cardiac imaging phenotypes and clinical biomarkers in young adults with hypertension. Through HyperEcho, our aims are:

1. To identify whether young adults with hypertension can be separated into different groups based on patterns of cardiac structure and function, as well as other risk factors.

2. To identify whether groups defined by cardiac structure and function and/or risk factors have different:

Severity and stage of hypertension

Type of hypertension i.e. primary or secondary and underlying diagnosis

Progression of hypertension during follow up and response to anti-hypertensive medication.

3. To identify novel imaging and circulating biomarkers that predict disease patterns or response to treatment.



Participants are characterised as hypertensive patients aged between 18 to 40 years old and referred to the hypertension clinic to manage their blood pressure. A patient and public involvement exercise has been performed to ensure this study design would appeal to patients attending the hypertension clinic, and to investigate the preferred method of contact.


The study visit will be carried out during the planned routine visit of the participants to the hypertension clinics of NHS trusts within England. Routine data will be collected by the assigned nurse for the hypertension clinic as part of the clinical service, and research participation will not affect the clinical progress of the participant. Potential participants will be asked to consent to the use of their data that has been collected in the hypertension clinic, such as; referral letters, medical history, 24-hour blood pressure monitoring report, ECG, blood samples, body fat composition, and dietary questionnaire. In addition to this, participants will be asked to consent to further review of their data and medical notes during their follow up visits (up to 10 years). The additional research component (for Oxford participants only) to the clinic will be asking the participants for their consent to undergo a research echocardiography scan if it has not been a part of their clinical assessment.


This study is supported with funding from the NIHR Oxford Biomedical Research Centre, the Saudi Arabian Cultural Bureau, and Oxford Cardiovascular Clinical Research Facility.


The study has been approved by the South West – Frenchay Research Ethics Committee (Reference 18/SW/0188)

More information can be found on

Contact the HyperEcho Team:

Maryam Alsharqi

Annabelle McCourt