P100: Trial of Exercise to Prevent Hypertension in Young Adults (TEPHRA): Rationale and Protocol

Abstract

Background

Hypertension or pre-hypertension in young adults is unusual and more often linked with an adverse family or pregnancy history, such as preterm birth, than hypertension which develops later in life^1–4. Surprisingly, no trials have investigated whether lifestyle advice developed for blood pressure control in older adults is effective in these young populations⁵.

Methods

TEPHRA is a randomised control trial of a 16 week physical activity intervention including behaviour change and structured exercise in young adults with pre- and stage 1 hypertension. On-line recruitment is used with targeting to ensure inclusion of a proportion born preterm. Primary outcome is 24 hr ambulatory blood pressure at 4 months. Subjects undergo additional multimodal assessments including vascular stiffness, blood sampling, microvascular assessment, echocardiography, remote activity monitoring and multi-organ magnetic resonance imaging to identify potential predictors of blood pressure change.

Results

Recruitment started in April 2016 and currently (June 2017) 344 potential participants have been screened with 103 progressing to a baseline visit, of which 91 have been randomized. Two participants have completed their 12 month follow up. Recruitment is predicted to be completed by February 2018 with data reporting of four months outcomes in late 2018.

Conclusion

TEPHRA aims to deliver the most in-depth investigation to date on the effects of physical exercise on the cardiovascular system and health of young adults at risk of early hypertension and cardiovascular disease.