UAB Chronic Hypertension and Pregnancy trial receives $12.8 million for follow-up and preeclampsia epigenetics studies

Consortium led by UAB researchers in the UAB Heersink School of Medicine and School of Public Health received additional funding to further study chronic hypertension and preeclampsia epigenetics participants enrolled in the CHAP trial.

Tita StreamAlan Tita, M.D., Ph.D., professor of obstetrics and gynecology in the UAB Heersink School of Medicine
Photography: Steve Wood
The University of Alabama at Birmingham and partner sites in the Chronic Hypertension and Pregnancy, or CHAP, consortium received $12.8 million from the National Institutes of Health to continue following women with chronic hypertension post-partum. 

Chronic hypertension is the most common major medical disorder encountered during pregnancy, occurring in up to 6 percent of pregnant women in the United States. The substantial negative effect of chronic hypertension on pregnancy includes a three- to fivefold increase in superimposed preeclampsia, placental abruption and adverse perinatal outcomes, including fetal or neonatal death, preterm birth, and poor fetal growth.

In 2014, the UAB Department of Obstetrics and Gynecology, the Center for Women’s Reproductive Health, and the Department of Biostatistics were awarded a $19.31 million R01 grant by the National Institutes of Health’s Heart, Lung, and Blood Institute to coordinate the most comprehensive study of chronic hypertension in pregnancy ever undertaken. Now at the end of the trial, with results anticipated within a few months, the Chronic Hypertension and Pregnancy Project consortium has been awarded an additional $10.5 million from the NIH/NHLBI to follow mothers enrolled in the program until five to 10 years following their completion of the trial to examine the long-term trajectory of hypertension and cardiovascular outcomes.

“The CHAP maternal follow-up study results will define how management during pregnancy affects the long-term cardiovascular health of reproductive-age women with chronic hypertension,” said Alan Tita, M.D., Ph.D., professor of obstetrics and gynecology in the UAB Marnix E. Heersink School of Medicine and contact principal investigator/project director for CHAP and CHAP Maternal follow-up. “It will specifically address the long-term maternal effects of preeclampsia and antihypertensive treatment during pregnancy in these patients.”

Other investigators include Suzanne Oparil, M.D., professor in the Division of Cardiovascular Disease; Jeff Szychowski, Ph.D., professor and chairman of biostatistics, Rachel Sinkey, M.D., assistant professor in the Division of Maternal-Fetal Medicine; Brian Casey, MD director of the Division of Maternal-Fetal Medicine; Anupam Agarwal, M.D., professor in the Division of Nephrology; Ronald Lazar, M.D., professor in the Department of Neurology and Paul Muntner, professor of epidemiology.

School of Public Health StreamRyals Public Health Building
Photography: Bruce Southerland
Additionally, the UAB School of Public Health also received an $2.3 million R01 grant in September 2021 to study preeclampsia epigenetics from samples from the CHAP trial.

Preeclampsia is a pregnancy complication that occurs around 20 weeks’ gestation and affects 2 to 8 percent of pregnancies in the United States and over 30 percent of pregnant women with chronic hypertension. It is characterized by more severe hypertension and signs of damage to other organ systems, such as the brain, liver and kidneys.

“Preeclampsia significantly increases the risk of maternal and fetal morbidity, including cardiovascular complications, preterm delivery, low birth weight and even death,” said Bertha Hidalgo, Ph.D., associate professor in the UAB Department of Epidemiology. “Furthermore, recent studies demonstrate that a history of preeclampsia is associated with an increased risk of cardiovascular disease for the mother later in life.”

Currently, the only definitive preeclampsia diagnosis is through blood pressure and urine protein measurement supplemented by blood tests in the second or third trimester. However, pathology starting in the first semester and earlier identification can allow for better treatment and outcomes. The ancillary study seeks to better understand the pathophysiology of preeclampsia and identify potential new biomarkers to facilitate early detection, management and treatment of this serious pregnancy condition.

The UAB CHAP Preeclampsia Epigenetics study team includes Hidalgo; Tita; Szychowski, Ryan Irvin, Ph.D., professor of epidemiology; Hemant Tiwari, Ph.D., professor of biostatistics; and Akila Subramaniam, M.D., associate professor in the Division of Maternal-Fetal Medicine.