Recipient organisationNIHR Bristol Clinical Research Facility
NIHR supportRecorded as supported by this research centre
PeriodFeb 2025 — Mar 2026
In plain English
AI plain-English summary
Black African-Caribbean women in the UK are 1.7 times more likely to develop high blood pressure than white European women, and their blood pressure surges more sharply during stress—yet no one has tested whether their brain’s blood vessels fail to protect against those surges. This matters because hypertension in Black African-Caribbean women is three times more likely to lead to stroke than in other groups. The researchers suspect that during stress-induced blood pressure spikes, the large vessels in the brain may not narrow enough to dampen pressure pulsations, leaving delicate small vessels vulnerable to damage. This study will directly test that mechanism for the first time, comparing 64 women—normotensive and hypertensive Black African-Caribbean women alongside white European counterparts—using brain MRI during mental stress. If the hypothesis holds, it would reveal a specific, measurable flaw in cerebrovascular control that explains the elevated stroke risk. That could shift clinical guidelines toward stress-management interventions or targeted blood-pressure treatments for this population, rather than treating all hypertensive patients the same. The work is applied clinical science, not fundamental research—its findings could directly inform how clinicians assess and manage stroke risk in Black African-Caribbean women.
View original technical description
There are differences in the rates of high blood pressure (BP) across ethnicities in the UK, with the highest rates in Black African-Caribbean women. Black African-Caribbean women are 1.7 times more likely to develop hypertension and hypertension is more likely to lead to stroke, contributing to the three times greater risk of hypertension-related mortality in this population. Chronic stress contributes to this elevated risk as Black African-Caribbean women experience larger surges in BP during stress, a predictor for future stroke. Yet, why periods of high BP are more likely to lead to stroke in Black African-Caribbean women is unclear. One potential reason is a reduced ability to dampen pressure pulsations the brain is exposed to during BP surges. Normally, large vessels in the brain narrow during BP surges, to protect the delicate smaller vessels from damage. However, this has not been examined in Black African Caribbean women. The primary aim of this study is to determine whether Black African-Caribbean women experience greater pressure pulsations in the large and small cerebral vessels during elevations in BP with mental stress, versus White European women. A secondary aim is to determine whether greater pressure pulsations during stress are associated with markers of damage to the small cerebral vessels, which is a leading cause of stroke. To assess these aims, we will recruit four groups (16 in each group, total of 64 participants): normotensive and hypertensive Black African Caribbean women and normotensive and hypertensive white European women. Participants will attend two visits: one screening visit at the Bristol Clinical Research Facility and one visit to Cardiff University Brain ImagingCentre where they will undergo a brain MRI. These findings will improve our understanding of cerebrovascular control mechanisms in Black African Caribbean women and help to explain why they have increased stroke risk
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