World Heart Day 2018: An Interview with Dr. Karen Tran

  1. What are hypertensive disorders? Do they affect pregnant women differently than non-pregnant women?

High blood pressure affects 1 in 4 Canadians and is the most common reason for Canadians to see their family doctors. Untreated high blood pressure is a major risk factor for heart attacks, strokes, heart failure, and kidney disease. Despite women being more likely than men to be treated for their high blood pressure, women are less likely to achieve blood pressure control.

In contrast, high blood pressure in pregnancy occurs in 5-10% of pregnant women, and accounts for a majority of maternal, fetal and neonatal morbidity and mortality. In BC alone, 1800 deliveries annually are complicated by hypertension and preeclampsia. Also, we know that pregnant women who having high blood pressure in their pregnancy are at increased risk of developing hypertension, cardiovascular disease, such as heart disease and stroke in the future.

2. In 2-3 sentences, could you briefly describe your research?

Together with Dr. Wee Shian Chan, we are interested in understanding how measuring blood pressure at home can improve how we care for pregnant women who develop hypertension during their pregnancies. We know that home blood pressure monitoring is more reliable than office blood pressure and associated with better outcomes in non-pregnant women, but we do not know if the same is true in pregnant women.

  1. What are some of the differences between how blood pressure is measured between pregnant women and non-pregnant women? Why are these processes different?

In non-pregnant women, home blood pressure monitoring leads to improved cardiovascular outcomes, adherence to medications, overall lower blood pressure, and increased patient satisfaction. There are also good recommendations on how often to measure blood pressure at home, as well as home blood pressure targets to achieve. This unfortunately is not the case for pregnant women. Currently, the diagnosis and management of high blood pressure in pregnant women rely on blood pressure measured in a doctor’s office, which can be inaccurate.

  1. How do these knowledge gaps currently impact pregnant women?

Even though, many doctors recommend that pregnant women measure their blood pressure at home, we are still not clear how often they should be doing this, what blood pressure they should achieve, how to use these blood pressure measurements to manage their care and whether or not this would reduce complications to mothers and their newborn babies.

  1. Why is this research important? How might it change clinical practice?

By measuring blood pressure at home, we hope to engage and empower women to take an active role in their health.  Many pregnant women already measure their blood pressure at home, but we require evidence to guide doctors on which home blood pressure thresholds to diagnose high blood pressure and what their home blood pressure targets should be to manage hypertension in pregnancy. Furthermore, we need to make sure that home blood pressures are measured accurately using validated blood pressure machines. In the future, we hope that clinicians will be able to rely on home blood pressure measurements to manage hypertension in pregnant women and improve the health of mothers and their new babies.