SuppliedKaitlyn Watson is an assistant professor in the faculty of pharmacy and pharmaceutical sciences at the University of Alberta. Her recent study found that for Canadian women, often the only way to get their high blood pressure symptoms taken seriously is to bring in evidence. The study was in collaboration with researchers at the University of Ottawa.
“Women have to take in proof when they go to the doctor,” Watson said. “Otherwise, their high blood pressure reading in the office may be dismissed.”
High blood pressure (hypertension) frequently presents without any noticeable symptoms; yet, its consequences are severe. Hypertension is one of the primary precursors to heart disease and dementia. Hypertension often presents with no symptoms in many patients, but signs can include shortness of breath, headaches, and dizziness.
In Watson’s study, women reported that keeping detailed home blood pressure logs was often the key to unlocking medication adjustments or further testing. “Women felt they were better able to advocate for themselves to show, ‘No, this is not a one-off reading. There is a pattern here. I am experiencing the same high levels … at home.”
Gaps in care
However, relying on home readings introduces an equity trap. While clinical guidelines recommend home tracking, it is not a requirement. Many patients are unaware of that distinction.
Requiring patients to buy home monitors creates financial and logistical hurdles. Validated home blood pressure cuffs can be a barrier for low-income individuals who lack disposable income. Accurately measuring and recording blood pressure at home further requires understanding specific positioning and timing protocols. This creates barriers for non-English speakers or those without knowledge of health-care terminology.
Watson expressed that access to a validated home blood pressure monitor requires “the luxury of the time, and the ability to sit down and do that on a regular basis.”
For patients who cannot monitor at home, alternatives exist in clinics. Automated Office Blood Pressure (AOBP) devices automatically take three accurate readings spaced minutes apart to average out stress spikes. However, these tools require clinics to actively offer them rather than defaulting to sending patients home with a shopping list.
Other alternatives instead of doctors
The dynamic between doctor and patient become even more unbalanced in rural, remote, or understaffed urban communities. When a patient in an isolated area experiences medical dismissal, finding another doctor is rarely an option due to family physician shortages in these areas.
To bridge this gap, Watson points to expanding the scope of practice for non-physician providers, particularly in Alberta. Under Alberta’s independent prescribing framework, pharmacists and nurse practitioners can diagnose, prescribe, and manage chronic conditions like hypertension. Pharmacists are far more accessible than family doctors, often requiring no appointments for a walk-in consultation.
Systemic bias in women’s health is further compounded when gender intersects with race, neurodivergence, language barriers, and/or socioeconomic status. Watson’s team is currently expanding their research to examine how community pharmacists can serve as frontline allies for rural women navigating hypertension. However, capturing data on these intersections remains one of health research’s steepest hurdles.
Watson noted that her study’s sample was predominantly white. Racialized and marginalized communities often participate in clinical studies at lower rates due to past medical exploitation. This creates a vicious cycle where homogenous data informs medical guidelines.
Furthermore, the study reported that women frequently report falling into an “invisible gap” in care between the reproductive and post-menopausal ages, when heart health complications tend to start.
“Typically, from our study, women felt really invisible … after the reproductive and childbirth premenopausal age.”
Watson noted that “there’s ways that we could perhaps do a better job of screening women at a younger age and not waiting until they’re 50 or 60.”
Beyond the physical risks of uncontrolled hypertension, there is a heavy psychological toll on women navigating health care. Being forced to self-advocate, research medical literature independently, and walk into appointments over-prepared just to be heard is an exhausting mental burden.
Future care and resources
To address these systemic flaws, Watson’s team is developing a targeted treatment framework titled, “Her Heart, Our Priority,” aimed at creating sex and gender-specific care pathways. It trains pharmacists to properly screen, treat, and improve access to care.
Resources from organizations like Hypertension Canada, the Canadian Women’s Heart Health Alliance, and the Heart and Stroke Foundation offer valuable guidance until systemic changes take root. However, the ultimate goal is a system where women don’t have to fight to be believed.
Watson highlights the importance of how women need to know they can be their own advocate. “Because, unfortunately, there are differences in health-care experiences based on many different factors, one of them being whether or not you are a woman in the system.”
