Dr. Berlacher

Dr. Katie Berlacher from the UPMC Heart and Vascular Institute discusses this serious blood pressure condition that puts some new moms at risk and talks about the launching of a new clinic designed to improve care.

Never Miss a Beat!

Get Healthy Tips Sent to Your Phone!

Message and data rates may apply. Text STOP to opt out and HELP for help. Go to https://pages.upmc.com/terms for privacy and terms.
array(11) { ["id"]=> string(7) "sms-cta" ["type"]=> string(4) "form" ["title"]=> string(36) "Get Healthy Tips Sent to Your Phone!" ["category"]=> string(0) "" ["subcategory"]=> string(0) "" ["keyword"]=> string(6) "HBEATS" ["utm_source"]=> string(0) "" ["utm_medium"]=> string(0) "" ["utm_campaign"]=> string(0) "" ["utm_content"]=> string(0) "" ["utm_term"]=> string(0) "" }

Read The Full Podcast Transcript

Tonia Caruso:

It’s a condition that can put new moms at risk after childbirth, postpartum hypertension, but there is a new approach to treatment that’s making a difference.

Tonia Caruso:

Hi, I’m Tonia Caruso. Welcome to the UPMC Health Beat Podcast and joining us right now is Dr. Katie Berlacher from the UPMC Heart and Vascular Institute. Doctor, thanks so much for joining us.

Dr. Katie Berlacher:

Thanks for having me Tonia.

Tonia Caruso:

And so what exactly is postpartum hypertension?

Dr. Katie Berlacher:

Postpartum hypertension is quite simply high blood pressure after you deliver. So we typically think of it as blood pressure. That is the top number 140 or the bottom number 90 or any numbers above those.

Dr. Katie Berlacher:

typically women who have had hypertension during pregnancy are more likely to develop high blood pressure after pregnancy.

Tonia Caruso:

And why is this so dangerous? What’s going on in the body?

Dr. Katie Berlacher:

Sure. Good questions. We don’t fully know all the answers to these yet, but quite simply high blood pressure is really the constriction of the blood vessels that supply all the parts of the body. So the pressure inside those arteries is a little bit higher than what we think is safe for anybody.

Dr. Katie Berlacher:

The reasons we worry about this are things immediately after delivering a child. If you have high blood pressure then you can develop things like shortness of breath. You can develop things like pulmonary edema, which is just extra fluid in your lungs that makes it hard to breathe. You can also later on down the line, develop things like chronic high blood pressure, heart attacks, strokes.

Tonia Caruso:

And so that’s why trying to find new ways to deal with this is so important. And talk about the new initiative underway and why you’re so excited about it.

Tonia Caruso:

This is really a partnership with the Heart Vascular Institute and Magee?

Dr. Katie Berlacher:

Because high blood pressure is something that can continue on much past your delivery, this is a time that you would need another physician, not your obstetrician, in order to help you with those. This hypertension clinic involves both the maternal-fetal medicine specialists and the cardiologists so that we can collectively see you together, make decisions together so that your care immediately after giving childbirth and then longterm care, where you move into things beyond pregnancy, are cared for collectively.

Tonia Caruso:

And so if someone is presenting with high blood pressure and hypertension, how do they get involved in the clinic? How do they get involved in the program?

Dr. Katie Berlacher:

Sure. Most of the time these women have high blood pressure at the end of their pregnancy or during delivery or shortly thereafter before they’re even discharged from delivery. And so the large majority of these patients, we catch at that point. Sometimes women go to their obstetrician’s office after they’ve delivered and their blood pressure is elevated at that point in time. And they are then referred to us.

Dr. Katie Berlacher:

Or if you would like to see us in the Heart Center at Magee, we are more than willing to see you if you think that your blood pressure is higher than it should be after you deliver.

Tonia Caruso:

And so how long has this been underway now?

Dr. Katie Berlacher:

We are only a few months in, but we’re really excited. It’s been very successful. Women love coming in to see us. They feel like they got a lot of great information and get to talk to two doctors at one session.

Tonia Caruso:

And so obviously as this was getting off the ground cases of COVID began to come to our region. And so we sort of had scaled back some appointments for a time and then talk about how that played into the clinic.

Dr. Katie Berlacher:

Sure. You know, it’s been a challenge for all of this everywhere. But specifically for this hypertension clinic where, you know, moms are juggling, new moms, especially are juggling a lot of different things. And so our goal was to make sure that they still received care.

Dr. Katie Berlacher:

We’ve used heavily telemedicine. So video visits and phone visits with all of our patients. They have blood pressure cuffs, most of them at home. So they can measure their blood pressure once or twice, or give us a pattern of blood pressures over those weeks after delivery. And then they report those numbers to us while we sit and chat with them over the video or over the phone.

Tonia Caruso:

And so now that we are moving on and sort of adapting to this new normal, are you at a point now where you’re asking people to come back in?

Dr. Katie Berlacher:

Yeah, we are. I would not say that it’s a hundred percent quite yet. We are kind of building to that and really ask our patients to work with us to help us determine what is best for them.

Dr. Katie Berlacher:

Honestly, many women feel that it’s harder to come in for a physical visit, given that they’re juggling transportation issues, children, and sometimes even older adults that they are caring for, in addition to their newborn. So sometimes it’s easier to do a video visit and we’re more than happy to do that. Other times they would like to come in and be seen in person. We’re also happy to do that now that we are able to from a safety standpoint.

Tonia Caruso:

And so ultimately, is this a longterm study, would you say? What are you hoping that ultimately the outcomes are that you can give to folks and expand throughout the health system? Why is it so important that you’re doing this now?

Dr. Katie Berlacher:

Sure. I mean, the primary reason that we want it is to make sure that these patients get care, right? That they don’t fall through the cracks, that they don’t have high blood pressure that gets untreated in that immediate period or beyond, most importantly, a lot of these women develop chronic hypertension. And that is something that we need to know about and something that they need regular followup for.

Dr. Katie Berlacher:

Second thing we really want is education, right? Education for other providers. But very importantly, for these patients, they need to know what that high blood pressure is. And like you were asking before, what it can do in the long run to harm them.

Tonia Caruso:

And so if someone is presenting with high blood pressure and has this hypertension, what are sort of, are there any simple tips or lifestyle changes that you try to impart on them that might be good for the rest of us to learn?

Dr. Katie Berlacher:

Absolutely. Some of the things that we start with, if we can’t, or don’t want to use medicines, we ask people to modify the amount of salt that is in their diet. So low salt diet, less than two grams of salt per day in your diet. We also encourage people to lose weight. Higher BMI’s or body mass index is associated with higher blood pressures. So we want people to lose weight and get back to a normal weight.

Dr. Katie Berlacher:

And finally exercise. Any sort of physical activity really helps bring down blood pressure over the longterm. So we encourage people to get into a daily exercise routine, and that doesn’t have to be training for a marathon in any way, shape or form. But just getting out and walking for 15 to 20 minutes. Playing with your kids, moving around is something that we want everyone to do.

Tonia Caruso:

Right. And then obviously, so all of this care is focused on new moms, but for women in general, health heart is very important.

Dr. Katie Berlacher:

Absolutely. For sure Tonia Caruso: (10:13) And so what sort of healthy messages would you want to give women and particularly signs and symptoms, they should look out for?

Dr. Katie Berlacher:

Overall women have the same signs and symptoms that men do actually. So the number one symptom that we, you know, talk to women about is chest pain. That’s the number one symptom that men have too. Women are, in addition to that, more likely to have other symptoms like shortness of breath, severe fatigue, things like neck pain and arm pain are a little bit more common in women if they are presenting with a heart attack.

Tonia Caruso:

Right. So now in this day and age, what is your advice? What kind of symptoms are there that folks should go to the emergency room or should call their doctor for a followup appointment?

Dr. Katie Berlacher:

Sure. So come into the emergency room any time that you have chest pain, severe or new shortness of breath. Anytime that you might’ve passed out. Those are the things that we really need you to come in and be seen immediately. Things that you might want to call your physician about to see if they want to see you in the office, or maybe just a telemedicine visit would be things like high blood pressure, palpitations, feeling like your heart is racing. Those sorts of things you can call the doctor and kind of have a discussion as to whether or not it’s time to come in urgently or to schedule a visit to be seen.

Tonia Caruso:

Right, and so there has been lots of fear after COVID, and worry “Is it safe to go into a hospital? Is it safe to go to a doctor’s office?”. What are your thoughts on that?

Dr. Katie Berlacher:

We’re taking a lot of precautions these days to make it as safe as possible for all patients and for all providers that work in hospitals right now. We do think that it’s safe for you to come in to see us. We’ve made a lot of modifications to our office areas. So you’ll see, when you come in to see a doctor that your wait room looks different. You’ll be spaced out. You might be sitting in a hallway before you go into your doctor’s office. This is all to protect you. Your doctor will be wearing a mask. You will most likely be asked to wear a mask. These things are all things that will keep you safe and will keep us safe.

Tonia Caruso:

Doctor, we thank you so much for coming in and spending some time with us today. Some great information. Thanks for joining us.

Dr. Katie Berlacher:

Thank you.

Tonia Caruso: I’m Tonia Caruso. Thanks for joining us as well. This is the UPMC Health Beat

 

About UPMC Magee-Womens Hospital

For more than a century, UPMC Magee-Womens Hospital has provided high-quality medical care to women at all stages of life. The U.S. Department of Health and Human Services recognizes Magee as a National Center of Excellence in Women’s Health. More than 9,000 babies are born each year at Magee. The hospital also treats men for a variety of conditions, including surgical treatment. The Magee-Womens Research Institute was the first center to focus research only on conditions involving women and their infants.