Amanda Wilde (Host): Millions of Americans are living with hypertension. Many can manage the condition with medication, but then there are those who are resistant to traditional high blood pressure medications. Jamaica Hospital recently opened a specialty center to. Treat patient's who are medication resistant. Next, we'll hear about the center and how medication resistant hypertension can best be treated with Dr. Ott Khalid, cardiologist at Jamaica Hospital Medical Center.

Dr. Khalid leads the hospital's Advanced Hypertension Practice Center where she focuses on diagnosing and treating resistant and complex forms of high blood pressure. This is Jamaica Hospital Med Talk from Jamaica Hospital Medical Center. I'm Amanda Wilde. Welcome. Welcome, Dr. Khalid.

Kainat Khalid, MD: Thank you so much for having me.

Amanda Wilde (Host): Well, as I mentioned, millions of Americans live with hypertension. Can you explain how many people are affected by resistance to the traditional medications And what that condition looks like in reality?

Kainat Khalid, MD: Yeah, of course. So high blood pressure or hypertension is one of the most common medical conditions in the us. And nearly half of all American adults, about 120 million people have elevated blood pressure. For most it's well-controlled with either lifestyle changes or one or two medications. But there is a group of patient's whose blood pressure stays high despite doing everything right.

we call this resistant hypertension. These individuals may be on three or more blood pressure medications, often at very high doses, and their numbers are still not in the safe range, and This is a much more complex form of high blood pressure and it requires specialized evaluation and advanced treatment strategies.

Amanda Wilde (Host): And what are the dangers for those who are resistant to traditional high blood pressure medication?

Kainat Khalid, MD: So resistant hypertension isn't just frustrating, it's also dangerous. Like you mentioned, when blood pressure remains uncontrolled, it dramatically increases the risk of heart attack stroke. Kidney failure, heart failure, and even cognitive decline. the good news is that when we identify resistant hypertension early And we treat it effectively, we can significantly lower the risks of these, conditions and help patient's live longer, healthier lives.

Amanda Wilde (Host): Jamaica Hospital recently opened a specialty center, which you had to treat patient's who are medication resistant. Can you explain what type of services you offer?

Kainat Khalid, MD: Yeah, of course. So at Jamaica Hospital's Advanced Hypertension Center, our whole focus is on patient's who have heart to control blood pressure. So we offer comprehensive multidisciplinary care, which means that patient's may not just see a cardiologist. But they may also be referred to a nephrologist, a kidney specialist, a sleep specialist, and other's depending on their needs.

So our center provides advanced diagnostic testing and personalized medication strategies, And we have much more newer therapies such as device-based treatments as well. We are one of the very few centers that are certified by the American Heart Association to provide this level of specialized hypertension care.

Amanda Wilde (Host): Can you explain in some detail some of the different types of tests that you offer and how they help you identify how you will treat your patient's?

Kainat Khalid, MD: we have several different tests, that we offer, resisted hypertension can have. Several underlying causes. So identifying the why is very critical. One thing we do is we use ambulatory blood pressure monitoring. This is a 24 hour device that measures blood pressure throughout the day and night, and it can help us seat the.

Blood pressure patterns outside of the doctor's office, which can give us clues to what could be going on. We also have advanced testing, such as CT scans and MRIs of the stomach to look at the kidneys And the arteries that supply the kidneys. cause sometimes that can be implicated in high blood pressure.

We also do a lot of blood and urine tests to look for hormonal conditions like thyroid problems, adrenal gland problems. And lastly, we do sleep studies. Because sleep apnea is one of the major hidden causes of resistant hypertension. Once we have all of these testing done, we can understand the root cause and tailor a precise treatment plan for each patient.

Amanda Wilde (Host): Well, speaking of treatment, I also understand that you offer a relatively new, minimally invasive procedure that can help. Can you provide the information on that?

Kainat Khalid, MD: one of the newest, treatments that we have, it's very exciting in the hypertension treatment world, it's called renal denervation. which is one of the most exciting advancements in hypertension treatment. the way it works is that the kidneys play a large role in regulating blood pressure, and they do this through a network of nerves.

In some people, those nerves are overactive. So renal denervation uses a catheter which is inserted in a blood vessel in the groin. it can gently disrupt those overactive nerves. It takes about an hour and it requires no incision. So it's a relatively fast procedure and it can have drastic results.

So we typically consider this option for adults that have resistant hypertension. By being on multiple medications or patient's who just can't tolerate higher doses of medication, every patient is carefully evaluated to make sure it's the right fit. But clinical trials have shown that there is a significant and sustained reduction in blood pressure after the procedure along patient's to use much fewer medication.

It's not a cure, but it is a very powerful tool that compliments lifestyle changes and medical therapy.

Amanda Wilde (Host): With all these tools at your disposal as far as diagnosis and advancements in treatment, what are the success rates that you are seeing with the center?

Kainat Khalid, MD: So we have actually very great success rates, initially when patient's come to us, they are either not on the correct medications or they just need advanced testing, like I mentioned earlier. Once we're able to identify the cause of what's exactly going on and get them on the right medications, a lot of people don't actually even need this procedure, but we can identify the ones that do And then we can, you know, improve their quality of life as well.

Amanda Wilde (Host): Beyond the range of treatment. Options offered at Jamaica Hospital. Are there lifestyle modifications that you recommend to your patient's who have uncontrolled hypertension?

Kainat Khalid, MD: Yes, definitely. So lifestyle plays a huge role in controlling blood pressure. Even in the resistant cases, so there's several different things that we recommend. One of the big things is reducing your sodium intake. So aiming for under 1500 to 2000 milligrams per day of sodium. The main way to do That is by avoiding prepackaged or prepared foods, like things like in cans and sauces and things like that.

And we really encourage people to cook as much as possible on their own. And along with that, you need a balanced diet, such as the dash diet or the Mediterranean eating patterns. Maintaining a healthy weight is also extremely important. Even a five to 10% reduction can lower your blood pressure along with regular physical activity, whether it's walking, cycling, swimming, anything that you enjoy.

We just recommend moving your body for about 30 minutes every day. Lastly, we recommend limiting alcohol, smoking, prioritizing your sleep, and managing your stress. All of those things alone may not treat resistant hypertension, but they significantly improve your results when combined with our other therapies.

Amanda Wilde (Host): That totally makes sense and pretty sound advice for anybody. How can someone. Learn more about the services offered at Jamaica Hospital's Hypertension Center.

Kainat Khalid, MD: So it's very easy to get more information or schedule an appointment. Patient's can visit Jamaica. Hospital's website under the cardiology website and learn much more about our advanced hypertension center. There you can also just ask your primary doctor for our referral, And we are happy to guide patient's who have struggled with high blood pressure for years.

Our goal is simple. We want to help patient's achieve a safer, healthier blood pressure and a better quality of life.

Amanda Wilde (Host): Dr. Khalid, thank you so much for describing what is available out there and plus how we can take hold of our healthcare too by making some modifications in what we're doing as well.

Kainat Khalid, MD: Yeah. Thank you so much for having me. I hope this helps you learn what you can do and where to go to get more help if needed.

Amanda Wilde (Host): Perfect Cardiologist, Dr. Ott. Khalid leads Jamaica Hospital's Advanced Hypertension Practice Center. For more information about the services Jamaica Hospital offers, visit our website at Jamaica hospital.org/podcasts. If you enjoyed this episode, please share it on your social channels and check out the entire podcast library for topics of interest to you.

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