Trial of Exercise to Prevent HypeRtension in young Adults (TEPHRA): Study Protocol

Wilby Williamson, Odaro Huckstep, Eleni Frangou, Afifah Mohamed , Cheryl Tan, Maryam Alsharqi, Marianne Bertagnolli, Winok Lapidaire, Julia Newton, Henner Hannssen, Richard McManus, Helen Dawes, Charlie Foster, Adam James Lewandowski, Paul Leeson

Research output: Contribution to journalArticle (Academic Journal)peer-review

4 Citations (Scopus)
209 Downloads (Pure)


Hypertension prevalence in young adults has increased and is associated with increased incidence of cerebrovascular and cardiovascular events in middle age. However, there is significant debate regards how to effectively manage young adult hypertension with recommendation to target lifestyle intervention. Surprisingly, no trials have investigated whether lifestyle advice developed for blood pressure control in older adults is effective in these younger populations.
TEPHRA is an open label, parallel arm, randomised controlled trial in young adults with high normal and elevated blood pressure. The study will compare a supervised physical activity intervention consisting of 16 weeks structured exercise, physical activity self-monitoring and motivational coaching with a control group receiving usual care/minimal intervention. 200 young adults aged 18-35 years, including a subgroup of preterm born participants will be recruited through open recruitment and direct invitation. Participants will be randomised in a ratio of 1:1 to either the exercise intervention group or control group. Primary outcome will be ambulatory blood pressure monitoring at 16 weeks with measure of sustained effect at 12 months. Study measures include multimodal cardiovascular assessments; peripheral vascular measures, blood sampling, microvascular assessment, echocardiography, objective physical activity monitoring and a subgroup will complete multi-organ magnetic resonance imaging.
The results of this trial will deliver a novel, randomised control trial that reports the effect of physical activity intervention on blood pressure integrated with detailed cardiovascular phenotyping in young adults. The results will support the development of future research and expand the evidence-based management of blood pressure in young adult populations.
Original languageEnglish
Article number208
Number of pages16
JournalBMC Cardiovascular Disorders
Publication statusPublished - 6 Nov 2018


  • Young Adult
  • Blood Pressure
  • Hypertension
  • Prehypertension
  • Preterm Birth
  • Randomised Trial
  • Exercise
  • Cardiac Imaging
  • Cardiac Remodelling
  • Cerebrovascular Health

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