Cardiovascular Risk Following HYpertenSive Pregnancy Throughout Adult Life (CRYSTAL)

Research summary

CRYSTAL is an observational study whereby participants will attend one 4 ½ -hour visit at 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 recruited from the ALSPAC cohort (G0 mothers cohort),75 will have had a hypertensive pregnancy and 75 will have had a normotensive pregnancy. At time of follow-up,they will be 30-35 years post pregnancy. Of the G0 cohort,2237 women experienced a hypertensive pregnancy. Participants will be invited by the ALSPAC study team to attend a study visit in Oxford where we will use MRI,echocardiography and other imaging modalities to study the brain,heart,and vasculature using our 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. Participants will first be given the opportunity to ask any questions and will provide written consent for the study. Participants’ anthropometric measures (waist-to-hip ratio,height and weight,body composition),resting blood pressures and an electrocardiogram (ECG) to identify atrial fibrillation will be taken. Cardiovascular risk assessment: Women will be invited to complete a questionnaire recording increased cardiovascular risk behaviours,medications,hospital admissions,and information regarding any other pregnancies. Participants may wish to complete this in their own time if not able to complete during the study visit. Participants will be examined for clinical features of heart failure and an assessment of symptoms will be recorded using the New York Heart Association score. Fasting blood tests (participants will be asked not to have any food or snacks at all for at least six hours before they come in for their study visit) to assess heart failure and cardiovascular profile (NT-pro-BNP,glucose/insulin levels,lipid profile,full blood count and renal function) will be obtained. Additional samples will be bio-banked for future potential analyses. Following the blood tests,participants will be offered snacks. Cardiac structure and function: Participants will undergo resting echocardiography,cMRI and CTCA. To look for features of cardiac dysfunction that are not evident whilst resting,a recognised characteristic of HFpEF,participants will also undergo a six-minute walk test,exercise stress echocardiography,as well as cardiopulmonary exercise testing (CPET) on a cycle ergometer. Optional measures: If time allows,participants will also undergo microvascular imaging (retina and ear). The study visit will conclude with participants being provided with a wrist-worn physical activity monitor to wear for 7 days following the study visit.

Principal Investigator

Prof Paul Leeson

Contact us

Email: cvm_nurses@cardiov.ox.ac.uk

IRAS number

330083