RecruitingObservational

Under stress: Why women of black African-Caribbean heritage are at elevated risk of stroke

This study aims to understand why women of Black African and Caribbean heritage are at a higher risk of having a stroke, often at a younger age. We believe stress might play a big part, as stress can cause larger blood pressure spikes in these women, potentially harming their brains over time. We want to see how the brain reacts to these blood pressure changes and if the brain's blood vessels are less able to protect themselves. By doing this, we hope to find ways to prevent strokes in the future. The study involves two visits to Bristol and Cardiff, including health checks, questionnaires, and brain scans. We are looking for women aged 18-75, both Black African/Caribbean and White European heritage.

At a glance

Status

Recruiting

Sponsor

British Heart Foundation

Enrolment target

Start

18 Feb 2025

Estimated completion

01 Oct 2027

Hypertension

What is this study about?

This research study, called 'Under Stress,' is trying to figure out a really important health puzzle. We know that women of Black African and Caribbean heritage are sadly three times more likely to have a stroke, and often have them when they are much younger, compared to other women. Currently, we don't fully understand why this happens.

Our researchers think that stress might be a key factor. When stressed, some women, particularly those of Black African and Caribbean heritage, can experience bigger and more frequent spikes in their blood pressure. Over time, these repeated high blood pressure surges could damage the delicate blood vessels in the brain, increasing the risk of a stroke. The study will look closely at how the brain responds to these changes in blood pressure and if the blood vessels in the brain are less able to protect themselves from these pressure spikes in Black women.

By taking part, you would be helping us gain a much clearer picture of this problem. Understanding the link between stress, blood pressure, and brain health in these women could lead to better ways to prevent strokes and improve healthcare for everyone. This study won't give medical advice, but it will help us gather vital information for the future.

Key takeaways

Understanding why Black African/Caribbean women have higher stroke risk.
Investigating the link between stress, blood pressure, and brain health.
Participation involves two visits (Bristol & Cardiff), lasting about 5 hours in total.
Includes health checks, questionnaires, blood tests, and brain MRI scans.
Helps develop future stroke prevention strategies.
Minimal risks, and you can withdraw at any time.

Who may be eligible?

We are looking for women aged between 18 and 75 years old to take part in this study. We need both women of Black African and Black Caribbean heritage, and women of White European heritage, so we can compare findings between these groups. It's important that participants are generally well, with a body mass index (BMI) under 35 kg/m2, which means they are not severely overweight.

We are looking for two main groups of participants. One group will have normal blood pressure, and the other group will have high blood pressure (hypertension). If you have high blood pressure, you can still take part if you are taking medication for it. Those with normal blood pressure can only be on oral contraception, but no other regular medications.

There are some reasons why you might not be able to join, as these could affect the study results or your safety. For example, if you have certain serious long-term illnesses like cancer, heart problems (other than high blood pressure), diabetes, or certain neurological conditions, you won't be able to participate. Also, if you are pregnant or breastfeeding, have a pacemaker, are a smoker, drink a lot of alcohol, or have severe needle phobia or claustrophobia (discomfort in small spaces like an MRI scanner), you won't be eligible. You also need to be able to understand instructions given in English.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you a woman between 18 and 75 years old?
Do you have a BMI under 35 kg/m2 (not severely overweight)?
Are you of Black African/Caribbean or White European heritage?
Do you have either normal blood pressure or high blood pressure that is being treated?
Are you able to speak and understand English?
Are you free from severe long-term illnesses (like cancer, severe heart, lung, or kidney disease, or diabetes)?

Answer every question to see your result.

What does participation involve?

If you decide to take part, your involvement will require two separate visits. The first visit will be to the Clinical Research Facility in Bristol and will last about 3 hours. During this visit, we'll do some initial checks to make sure the study is suitable for you. You'll complete questionnaires about your lifestyle, diet, sleep, stress levels, and any experiences of discrimination. We'll also measure your blood pressure and blood flow in your legs while you do a maths task, and take a blood sample to check stress hormone levels.

The second visit will be to the Cardiff University Brain Imaging Research Centre and will take around 2 hours. Here, we'll measure the stiffness of your large arteries. Then, you'll have a brain MRI scan. This scan will be done while you are resting, while you do a mental maths task, and also while a blood pressure cuff is inflated around your forearm for a short period to briefly stop blood flow. This helps us see how your brain's blood vessels react to different challenges. The total duration of your participation, including both visits, will be approximately 5 hours spread across two days.

Potential risks and benefits

Taking part in this study offers the benefit of a full blood pressure check, and you'll also receive information about your cholesterol levels and diabetes risk, which can be useful for your general health awareness. Most importantly, your involvement will contribute to understanding why stress increases stroke risk in Black women, potentially leading to new ways to prevent strokes in the future. The risks of participating are generally minimal. You might feel a little discomfort from needle sticks for blood tests (which could cause mild swelling or bruising), from blood pressure cuffs on your finger or arm, or from the mental maths tasks which might be a bit stressful. An MRI scan is safe and painless, but some people find the enclosed space difficult, or lying still for an hour uncomfortable. You are free to withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (2)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

NIHR Bristol Clinical Research Facility
City only
Bristol, United Kingdom
Cardiff University Brain Imaging Centre
City only
Cardiff, United Kingdom

Common questions

Why is this study specifically looking at women of Black African and Caribbean heritage?

Because women from these backgrounds are three times more likely to have a stroke, often at a younger age, and we want to understand why to help prevent it.

What exactly will I have to do during the study visits?

You'll fill out questionnaires, have blood pressure and blood flow checks, give a blood sample, and have an MRI scan of your brain while doing different tasks.

Will I get any results from my participation?

You will get a full blood pressure screen, and information on your cholesterol levels and diabetes risk.

Is the MRI scan safe?

Yes, MRI is a very safe medical procedure. It doesn't use radiation. Some people might find it a bit noisy or feel uneasy in the scanner, but you can always communicate with the staff.

How long will the study go on for?

The study started in April 2024 and is expected to run until January 2028.

How to find out more

Lydia Simpson

Lydia.simpson@bristol.ac.uk +44 (0)7795123830 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.