Current state of affairs: A study regarding diagnosis, treatment and use of home blood pressure monitoring for hypertension in pregnancy.

Abstract

Guidelines for management of hypertension (HTN) in pregnancy have evolved to recommend "tight" control and increased use of home blood pressure (BP) monitoring. This survey-based study examined the preferred methods for diagnosing, investigating and managing HTN in pregnancy among two groups of prenatal care providers at a tertiary care hospital: Family Physicians and Obstetricians. The response rate was 75%. Obstetricians were significantly more likely to use home BP monitoring while Family Physicians were significantly more likely to use 24-hour ambulatory BP monitoring to aid with diagnosis (p=0.008). For surveillance, more Obstetricians believed home BP monitoring was validated in pregnancy (78.3% vs 42.9%, p=0.02) and were more likely to monitor HTN with home readings compared to Family Physicians (91.7% vs 64.3%, p=0.02). Family Physicians were significantly more likely to target "tight" BP control compared to Obstetricians (93.8% vs 72%, p=0.03). This single centre study demonstrated relatively high uptake of newer BP target recommendations in pregnancy, however there remains a significant variation in the use of home BP monitoring for diagnosis and surveillance of HTN in pregnancy between the two specialties.