Paediatrics and cardiology Circulatory System
Conditions
Interventions
Current methodology as of 07/08/2026:
PARTICIPANTS
Children and young adults with primary hypertension aged 10-35 years will be approached by a member of their direct clinical care team. We aim to rec
Sponsors
King's College London
Eligibility
Sex/Gender
All
Age
10 Years to 35 Years
Inclusion criteria
Inclusion criteria: 1. Aged 10-35 years old 2. Primary hypertension (intervention group) or BP < 90th centile (control group) 3. Able to tolerate the planned investigations 4. Not currently on anti-hypertensive medication/s or able to stop anti-hypertensive medications for 2 weeks prior to any research-related assessments. Additional inclusion criteria control participants: 5. BMI in the "normal" range for age
Exclusion criteria
Exclusion criteria: 1. Secondary hypertension 2. Clinical urgency to commence anti-hypertensive or unable to stop anti-antihypertensives for 2 week washout period 3. Unable to obtain adequate quality of planned cardiovascular investigations 4. Congenital heart disease 5. Cardiac dysrhythmias 6. Pregnancy or lactating mothers Additional exclusion criteria for medication 1 (bisoprolol challenge): 7. Asthma currently treated with medication 8. Cardiac conduction abnormalities 9. Known intolerance to bisoprolol Additional exclusion criteria for medication 2 (amlodipine challenge): 10. History of angina or myocardial infarction 11. Known intolerance to amlodipine
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Current primary outcomes as of 07/08/2026: 1. Cardiac output measured MRI at baseline in hypertensive participants compared to healthy controls 2. Aortic ejection velocity measured using MRI at baseline in hypertensive participants compared to controls 3. Arterial stiffness in hypertensive participants compared to healthy controls, measured using MRI and carotid-femoral pulse wave velocity at baseline 4. Reduction in arterial stiffness in hypertensive subjects after therapeutic reduction in blood pressure, measured using MRI and carotid-femoral pulse wave velocity at baseline and when adequate blood pressure reduction is achieved (duration of time required to achieve this may be variable) Previous primary outcomes: 1. Cardiac output measured MRI at baseline in hypertensive participants compared to healthy controls 2. Aortic ejection velocity measured using MRI at baseline in hypertensive participants compared to controls | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcomes as of 07/08/2026: 1. Cardiac output measured using an echocardiogram before and after i) slow breathing exercise, ii) amlodipine administration and iii) bisoprolol administration 2. Aortic ejection velocity measured using echocardiogram before and after i) slow breathing exercise, ii) amlodipine administration and iii) bisoprolol administration 3. Pulse wave velocity measured using applanation tonometry before and after i) slow breathing exercise, ii) leg venous occlusion, iii) amlodipine administration and iv) bisoprolol administration 4. Systemic vascular resistance, heart rate, stroke volume and pulse wave velocity measured using MRI at baseline in hypertensive participants compared to controls 5. Changes in aortic stiffness after acute change in thoracic pressure with breathing manoeuvres in hypertensive subjects compared to controls, measured using aortic pulse wave velocity at study baseline in healthy controls, or at baseline and/or at time of adequate blood pressure reduction for hypertensive subjects (duration of time required to achieve this may be variable) Previous secondary outcomes: 1. Cardiac output measured using an echocardiogram before and after i) slow breathing exercise, ii) amlodipine administration and iii) bisoprolol administration 2. Aortic ejection velocity measured using echocardiogram before and after i) slow breathing exercise, ii) amlodipine administration and iii) bisoprolol administration 3. Pulse wave velocity measured using applanation tonometry before and after i) slow breathing exercise, ii) amlodipine administration and iii) bisoprolol administration 4. Systemic vascular resistance, heart rate, stroke volume and pulse wave velocity measured using MRI at baseline in hypertensive participants compared to controls | — |
Countries
England, United Kingdom
Contacts
Public ContactLouise Keehn
Outcome results
None listed