Hypertension Related Damage to the Microcirculation in South Asian: Emergence, Predictive Power and Reversibility

Summary

Damage to very small blood vessels is a consequence, but can also precede high blood pressure. Such damage, measured by disturbances in the vessels in the retina (back of the eye) is a strong predictor of heart disease and stroke. South Asian people have one of the highest rates of hypertension in the world (30% in adults). In Pakistan, this is usually severe, undetected and untreated. The Wellcome Trust has already funded a study of blood pressure control in adults and children in this population. We propose a substudy, taking photographs of the retina and making measurements of the vessels, to determine whether such blood pressure related changes occur at an early age in young children with a family history of high blood pressure compared to those without, whether such changes predict an increase in blood pressure over time, and whether, in adults, such changes can be reversed by blood pressure treatment. The hypothesis of our study is: young offspring of South Asian people with hypertension have a disturbed microcirculation, as assessed by abnormalities of retinal vessels, compared to offspring of normotensive parents. Our 2nd hypothesis is: Abnormal retinal vascular geometry will improve proportionately to achieved reductions in BP.

Conditions

• Hypertension
• Diabetes
• Cardiovascular Disease
• Retinopathy

Interventions

BEHAVIORAL

GP training and Health Education

Sponsors & Collaborators

• Imperial College London

  collaborator OTHER

• Aga Khan University

  lead OTHER

Principal Investigators

• Tazeen H Jafar, MD, MPH · Aga Khan University

• Nish Chaturvedi, MD, MFPHM · Imperial College London

• Alun Hughes, MD, Phd · Imperial College London

• Juanita Hatcher, Phd, MSc · Aga Khan University

• Simon Thom, MD, FRCP · Imperial College London

• Khabir Ahmad, MD, MSc · Aga Khan University

• Muhammad Saleem Khan, MSc Epi&Bio · Aga Khan University

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

FACTORIAL

Eligibility

Min Age

9 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2006-05-31

Completion

2009-06-30

Countries

• Pakistan

Study Locations