Active Heart, Stroke & Blood Bones, Joints & Muscles

Arterial stiffening and hypertension in children and young adults

Funder BHF Charity-funded
Recipient organisation King's College London
Funding £332K
Period Feb 2025 — Oct 2028

In plain English

AI plain-English summary

A child’s stiff aorta can drive up their blood pressure, and doctors don’t yet know why. In adults, stiff arteries are usually a sign of age-related wear and tear, but in children and young people with hypertension, the cause is unclear. This project will test three possible explanations: that the artery stiffens simply because it is under higher pressure, that overactive sympathetic nerves are tightening the vessel wall, or that the child’s aorta is naturally narrower, creating more resistance. The team will measure aortic stiffness in hypertensive young people before and after their blood pressure is normalised, and also after experimental interventions that isolate the effects of pressure alone and nerve activity alone. MRI scans will reveal whether a smaller aortic diameter is the culprit. This is the first detailed mechanistic study of arterial stiffness in hypertensive children and young people. The work is primarily fundamental science—it asks *how* the problem arises—but a clearer understanding could eventually allow clinicians to choose treatments that target the specific mechanism in each patient, rather than using a one-size-fits-all approach.

View original technical description
Aortic and large artery stiffness is increased in children and young people (CYP) with hypertension compared to normotensive controls. It contributes towards raised systolic blood pressure (BP) in CYP and a rise in BP over time that is likely to contribute to the burden of hypertension in the adult population. The cause of arterial stiffening in CYP is unlikely to be the age-related degenerative changes in connective tissue seen in older people. Other mechanisms include a pressure-dependent increase in stiffness due to raised mean arterial BP, increased sympathetic tone and smaller aortic diameter. The aim of this study is to distinguish between these possibilities by measuring aortic stiffness in hypertensive CYP before and after normalisation of BP and before and after experimental interventions to assess mechanical effects of BP alone and sympathetic tone alone; the role of aortic diameter will be examined by direct measurement using MRI. This project will represent the first detailed examination of arterial stiffness in CYP with hypertension. Whilst the focus of the present application is primarily mechanistic, it will inform a more stratified approach to the treatment of hypertension in CYP and identify tools with which to implement this.

View the original record at the funder ↗

Researchers

Manish Sinha (EPMC Awardee)

Related Research

Grants with similar aims, by meaning.

The Evaluation of blood pressure treatment stratified according to Central Aortic Systolic Pressure (CASP) in Young Hypertensive Patients - The TREAT CASP study
Haemodynamic Determinants Of HYpertension In Children And Young People And Role Of The Sympathetic Nervous System: HY CYP
Early Life determinants of Blood pressure patterns in young Adults (ELBA Study).
Why do children develop hypertension after coarctation repair?
Aortic stiffness: mechanisms and clinical importance

Original classification

None

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