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CRYSTAL (Cardiovascular Risk Following HYpertenSive Pregnancy Throughout Adult Life)

STUDY BACKGROUND

Women who develop blood pressure problems during pregnancy have an increased risk of developing future cardiovascular disease including high blood pressure (hypertension), heart failure, heart attacks or strokes. Our previous work has shown that changes in the heart and blood vessels which develop as a result of hypertension during pregnancy can persist over years. Examining such changes could help us in our understanding of why there is the increased risk of cardiovascular disease. We think that some women who experienced hypertensive pregnancy may develop early changes of heart failure with preserved ejection fraction, that initially do not cause any symptoms but could progress if left undetected.

STUDY OBJECTIVES

Our aim is to understand the heart and blood vessel changes in women who experienced a hypertensive pregnancy compared to women who experienced normal blood pressure in pregnancy. We are particularly interested in studying changes suggestive of heart failure with preserved ejection fraction. We will do this by performing detailed heart and blood vessel imaging on 150 women recruited from the Avon Longitudinal Study of Parents and Children (ALSPAC), who are now in their 60s and 70s, half of whom have previously had a hypertensive pregnancy. We will link the imaging findings from this study with the existing, detailed, prospective data already collected about these women, to try and develop new ways to prevent early onset heart and blood vessel disease in women whose pregnancies are complicated by hypertension.

STUDY RECRUITMENT

We are undertaking a follow-up of 150 mothers from the Avon Longitudinal Study of Parents and Children (ALSPAC) study, a longitudinal birth cohort study based at the University of Bristol. Of the 150 mothers followed up from the ALSPAC study, 75 will have had a normotensive pregnancy, and 75 will have had a hypertensive pregnancy.

STUDY VISITS

There is one study visit as part of the CLARITY Study which will last up to 5 hours. This visit will take place at the John Radcliffe Hospital in Oxford. The visit will include an MRI and CT scan, and echocardiography (ultrasound) to take pictures of the heart, lung function assessment (spirometry), exercise testing, recordings of blood pressure, as well as retinal and ear microvascular imaging (collecting images of the small blood vessels in the back of the eye and the ear), and blood sampling. During this visit, we will also collect demographic and anthropometric data, and you will be asked to complete a questionnaire. The study visit will finish with you being provided with a wrist worn activity tracker to wear for 7 days.

RESEARCH FUNDING

The study is supported with funding from the Medical Research Council.

STUDY APPROVALS

The study has been approved by the West of Scotland Research Ethics Committee (Ref: 25/WS/0009).

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