August 12, 2025 • 29 mins
Dr. Sandeep Rao brings the borderland the latest information in healthcare, medicine and technology. He considers himself a hacker in the positive sense, using his intimate knowledge of the medical system to break down some of the barriers to accessing new medical technologies and information.
For more information call Dr. Rao's office at 915-500-4370 or email Rao@medicalhackers.com
Be the first to hear the show in News Radio KTSM-AM Saturdays at noon, an iHeart station.
For more information call Dr. Rao's office at 915-500-4370 or email Rao@medicalhackers.com
Be the first to hear the show in News Radio KTSM-AM Saturdays at noon, an iHeart station.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Good afternoon. This is know the weekend here in the
heart of the dusty Chuaha Desert in West Texas. You're
listening to the Medical Hackers. However, you may be tuned
in this week and I'm your host, doctor Sandeep Raw.
We're here to bring the bordering of the latest information healthcare, medicine,
and technology on the show. I consider myself a hacker,
A hacker in the positive sense, A hacker used my
(00:26):
intimate knowledge of the medical system to helping breaking down
some of the bearish accessing new medical technologies and current
healthcare information. I have a fellow medical hacker here in me,
a fellow doctor. I don't have many guests on the show,
but I do have a guest doctor who.
Speaker 2 (00:46):
I recently met. He recently moved.
Speaker 1 (00:48):
To al Paso by way the Midwest, which is also
a little bit of my path here. I came here
from Ohio State. He came here from Indiana University. I
have doctor upper Khan. Good morning, you have your doctor
con So you're also by way of southern California. There
are a lot of There are a lot of Californians
I know I've seen moved to move to l Pass
and moved to this area. But I am interested to
(01:11):
know you are a nephrologist. You're a doctor of the kidneys.
I deal with the kidneys. You know, kidneys affect every
part of everybody's practice. For for me, you know, the
way kidneys affect me and my practice is we always
try to find out what patients renal function is before
I do a procedure, because some of the medications I
given a procedure affect the kidneys, can possibly impact the
(01:35):
renal function. But I'm actually just curious on a very
very high level, as a super specialized doc, a kidney doc.
You know, you you went through like myself. You obviously
went to med school for his med school, then you
did your careers of training as a internal medicine, then
you did your then you did your kidney fellowship. Right,
I'm curious, you know, how did you arrive to focus
(02:00):
on the kidneys, because there's so many different pathways as
the internal medicine doc, you can do. You could focus
on the kidneys, you can focus the heart, you could
do the lungs like like my dad did the lungs.
But I'm curious what drew you to the kidneys. It's
a very you know, it's a very different specialty.
Speaker 3 (02:15):
Yes, thank you, doctor Raw being a kidney doctor recently graduated,
the very kind words thank you.
Speaker 2 (02:24):
Yes.
Speaker 3 (02:25):
Going into nephrology, as we say, kidney medicine, first, you
have to go through internal medicine, which was my ultimate
favorite specialty given the giant area that it covers and
including lots of many different diseases and just taking care
(02:45):
of patients. In a sense, internal medicine is very broad
and once you enter internal medicine, then you have the
chance to either enter other subspecialties, either cardiology, gastroontrology, or nephrology.
The reason I chose nephrology was pretty sick simple, and
I go back to seeing my attendings in residency and
(03:05):
noticing how each attending had their unique flavor on how
to approach patients in the hospital. And with nephrology, I
noticed that my attendings were kind of different, almost normal.
So when I compared these two other doctors cardiologists, gastroentrologists, endocrinologist,
I noticed that these people just didn't align with what
(03:29):
I was going for, and nephrology appealed to me for
the normalcy. I had many attendings that I could relate
to on a personal level, family level, And so I
would say, because I noticed that they had normal lives,
they had time for their family, time for you know, activities,
and I couldn't see that myself and other specialties. So
(03:50):
if that's an answer, I guess because we're kind of normal.
Speaker 1 (03:54):
That it's a great answer because in a sense, a
lot of what drawss are in any pathway is being
able to identify ourselves or our future selves in that field.
So for me, I come from you know, people ask
me why am I a doctor in the first place,
not specifically vascular interventional radiology, but why my doctor? And
the thing is, there's so many docs in my family,
so I can easily see myself in that space. One
(04:17):
of my uh sort of friends is a musician, and like,
I could never see myself going to me into that,
but he said, you know, my dad was a musician,
my grand so so there's a lot of a lot
of mentors that guide you throughout, you know, your development,
your journey. And if you see somebody doing what you
could see yourself doing that job, I think that's kind
(04:38):
of what what brings you in. And so I think
I think good mentorship I think is in general is good.
So if there's anybody who listening out there who is
interested about medicine, I think, you know, finding docs or
find finding people who you can possibly relate to that
makes it a lot more easy to sort of to
get into. But you know, the thing about what I
like about the kidneys, To me, I feel like the
(04:59):
kidneys are are I don't know. Maybe you can correct
me if I'm wrong, because I don't think about this
too much. Okay, but obviously we have a we have
a brain. The brain controls our body. But to me,
the kidney to a certain degree, I feel like it's
like there's like this, you know, this control room in
like a warehouse, and there's some there's some genius, there's
kind of making sure everything is going right. Sure, you know,
there's so many moving parts in our body. There's so
(05:21):
many different parts of our body that the kidney impacts. Sure,
we have two kidneys. We could theoretically lose one. We
could donate your kidney, Yes you can. But I think
the kidney is such an important part of your body
because a lot of focus people focus on maybe you know,
heart disease. You know, if you were asked someone what's
the most important organ in the body.
Speaker 3 (05:42):
You know, I have I have an answer for you,
doctor Rout. So I I rank the body's organs. I
go the top three. Number one we got the brain,
Number two we got the heart, and number three is
the kidney. You know, I get a lot of flak
for that because I have the pominologists saying, hey, we
have two lungs too, and you have two kidneys or no.
(06:04):
I would always say, yeah, I have two kidneys. Of
course I'm going to be in the top three. And
I have my pumonologists chime in saying, you know, hello,
we got two of them.
Speaker 2 (06:12):
Two.
Speaker 3 (06:13):
The thing with kidney disease, with kidneys is that it's
our bodies are so complex. It's a beautiful thing. We
have some of the most complex anatomy physiology. What happens
with kidneys is that it's intertwined with everything. We have
hormonal feedback mechanisms, we have you know, whether it's blood pressure,
(06:34):
whether it's due to I can name a hundred of them. Kidneys, yes,
are very important, along with heart and brain and the lungs.
But the kidneys are unique because they are they are.
Speaker 2 (06:48):
The kidneys are unique. I wish I had a better answer.
It's like you, you gave me the alley you but
uh sure.
Speaker 3 (06:55):
What's unique about the kidneys, I would say, is that
it has to do with many things. Whether it's diabete,
whether it's hypertension, whether it's you know, you have osteoporosis.
There's all these different mechanisms that go through the kidneys
which make it a vital organ.
Speaker 1 (07:10):
And that's probably part of the reason why I specifically
did not want to be a nefrology. So to me,
I feel a nephrology is you have to really really
understand physiology. So when you're going through medical school, you know,
we take classes in anatomy, we take classes in a pathology,
in a you know, different field physiology, right, And so
(07:34):
for me, physiology is very complex and you have to
know that really well. You have to know how different
you know, enzymes, different hormones, things interact in your body.
And so for me, I actually enjoyed just the global
idea of, you know, the anatomic way of looking at
like that's what drew me into surgery initially and then
into vascuel or interventional that's where I'm doing procedures largely,
(07:56):
but nephrology is very much a thinking man's facility, you know,
thinking man's game there. So for me, I don't I
don't want to say that I'm not a thinker.
Speaker 2 (08:05):
You're very smart, doctor, I don't don't say that about
but I.
Speaker 1 (08:08):
Do enjoy working with my hands more and I think
that's what really makes nephrology very unique. It affects a
lot of parts of the body. There's a lot of
moving parts as we know, and there's so many interactions
that I don't think I was ever able to truly
truly grasp it. And that's what it's great to have
docs like you in this. So we're going to take
a quick little break here on the Hackers and I'm
(08:30):
going to come back with doctor kN here and we're
going to go into sort of what are the major
roles the kidney's play in the body, but specifically we
kind of want to do a little bit of a
dive into high blood pressure hypertension, which is really something
that there's some really interesting new developments in this area.
Speaker 4 (08:48):
So quick break here, you're listening to the Medical Hackers
with doctor Sandy Brow, board certified vascular interventionalist bringing you
insights on treatments for common medical problems on news radio
six ninety KTSM. For more information on the issues being discussed,
or to contact doctor Rao, call nine one five five
(09:08):
hundred four three seven zero or by emailing Rao at
medical hackers dot com.
Speaker 1 (09:17):
Back here on the Hackers, I'm doctor Rau here with
my special guest, doctor ukber Khan, and we've been initially
talking about his journey into the field of nephrology. But
one of the most important aspects that nephrologists have in
terms of a patient's disease processes is their role in
blood pressure, among many other things. Now, you know, we
(09:40):
look at blood pressure, Only twenty three percent of individuals
in the US with high blood pressure actually achieve their
treatment goals. So that means only one in four. So
if you're out there and you have high blood pressure,
find four other people with you who have high blood pressure,
only one in four of you actually will achieve the
(10:00):
goal that we, as a doc have set out for you.
And that's I think that's kind of a that's not
a great number. If I said, you know, our success
rate is like one in four, and so really there's
a lot of new treatments coming out. My particular interest
and I'm not going to get into this at all
on this show, is this area called the developing area
which we're trying to look at called renal denervation. That's
(10:21):
a procedural way and it's a cather based approach to
go after the nerves that sort of energize the kidney,
that get feedback from the kidney, the renal sympathetic nerves.
And it's a way to sort of get patients off
of these blood pressure medications or at least better control
them with blood pressure medications. I think it's difficult for
(10:44):
me to say get them off because I think all
patients are going to have to be on some pressure medication.
But really, high bloodresure is such an important role thin
in this in right, so it is the leading risk
factor for heart disease in the US and globally and
debth so so it's it's so important that people meet
their blood pressure goals. And so I guess a question
(11:07):
that I have for you, doctor, con Yes, blood pressure goal.
Your patient comes in very very high level, you know,
like you know what is what is their you know,
patient comes in at what point do you want to
a intervene and start giving them medications.
Speaker 3 (11:23):
Yes, that's a loaded question, doctor Rout. Hypertension extremely important,
as you are alluding to. It's the leading cause of
UH morbidity and mortality globally and in the United States
morbidity and mortality. People die with hypertension, and it's a
(11:43):
scary thing. I won't I won't beat around the bush.
It's not fun seeing young people going undiagnosed, not treating
themselves and ending up on the dreaded dialysis because of
hypertension and its downstream effects. When I see somebody with hypertension,
my main goal is first of all, identifying that it
(12:04):
is hypertension. We go through you know, we have very
detailed guidelines with you know, American Heart Association, the American
Society of Nephrology. There there are so many different guidelines
and societies that you know, you discuss hypertension. So when
we first diagnosed, we know that you have hypertension, which
is when a patient will be will be seen with
(12:26):
the blood pressure above one forty on two separate visits
within two weeks. You have to have this as your
official diagnosis. So just because you have one read at
the local Walmart and you're you know you're scared because
you think you have hypertension. Remember hypertension is officially diagnosed
two weeks. Wow, two different readings within two weeks at
(12:50):
different times, okay, And you know, just even getting the
right blood the accurate blood pressure is also important, which
I like to touch.
Speaker 2 (12:58):
You know.
Speaker 3 (12:59):
I see people with BP monitors on their wrist a
little FYI never use that people.
Speaker 2 (13:06):
The wrist BP monitor does not work.
Speaker 3 (13:10):
It's very inaccurate, and it's sad that we push this
sort of technology on all of our people to get
a good reading for blood pressure, which is actually interesting.
There's papers written on how to sit down and take.
Speaker 2 (13:23):
Your blood pressure. It would be at least.
Speaker 3 (13:26):
Five minutes or two to three minutes of not walking,
sitting in a chair. Your legs are not crossed, your
arms are by your side. It's on your upper arm,
the BP cuff. It has to fit right. There's certain
things you have to do to make sure you even
have high blood pressure. But once you are diagnosed with that,
the first thing we attack is what are you eating?
Speaker 2 (13:45):
What is your diet like?
Speaker 3 (13:46):
There's so many lifestyle changes that we put into medicine,
and this is the most important one. Blood pressure how
much salt you're taking, what's your diet, like fast food,
processed foods, all this sort of jazz that can go
into blood pressure. And once that's diagnosed, then you can
come to me as a kidney doctor, as a subspecialist,
and we take it a little further.
Speaker 2 (14:06):
So in that regard, just.
Speaker 3 (14:08):
Being diagnosed with high pertension alone is a big thing,
and you know, lifestyle changes is the first thing that.
Speaker 1 (14:14):
We go for sure. So there's a stat that I
have here. So out of the one hundred and twenty
million adults in the US, so that's about a third
of the US population actually who has high blood pressure,
three percent, as I said, have controlled pressure, which that
means they can get to their target of at least
target goals under a one point thirty over eighty, okay,
(14:36):
And forty five percent of any of these patients out
of these one hundred and twenty million adults, forty five
percent of these patients apparently have blood pressure readings above
one forty over ninety, which means, according to your thing,
maybe they should seek out a medical professional. So here's
my bigger question. There's so many docs who treat blood pressure.
(14:57):
Do you have your primary care doc so that maybe
they have a cardiologist. I don't know how many patients
have a nephrologist in their in their rolodex they need
to call upon. And so my question is, at what
point does it merit if a doc is listening to
the show, if a nurses listening to the show, or
if you're a patient listening to the show, at what
(15:19):
point should I call up, you know, pick up the
phone and say I need to see doctor Kahn. I
need to see a nephrologist to handle this. At this point,
you need to be step into the picture. What makes
nephrology you know, what brings you into the short?
Speaker 2 (15:33):
Yeah.
Speaker 3 (15:34):
When I entered my fellowship, it was Nephrology and Hypertension.
Speaker 2 (15:38):
I was a little intimidated. Wow the name of your phone.
Speaker 1 (15:40):
Yeah, oh so my pretension was part of the Oh yes,
I know. I didn't realize that. You know, it's kind
of interesting because I always think I associate high blood
pressure with cardiology. You never think of nephrology as a
front line.
Speaker 2 (15:53):
Well, thank you for not knowing that, doctor.
Speaker 3 (15:56):
Aw uh we Actually I recall having it on my
lab coat and I loved sporting that Nephrology and Hypertension
fellow you know in my training, and that is an
excellent question. Remember, medicine, like you know, doctor Rao is
includes all the specialties together. It's it's preventive. Like I
don't want I don't want to see you as a
(16:17):
patient for hypertension, then I know that something wasn't going down,
wasn't going correctly the other way. But we welcome all consults.
We want people to reach out to us for this.
Speaker 2 (16:26):
So for actual a patient to come see us. Let
me put it this way.
Speaker 3 (16:32):
So diabetes obesity, we know that hypertension is almost eighty
five to ninety percent. It's in patients who have diabetes
and chronic kidney disease. This is what you know our
bread and butter and nephrology, chronic kidney disease, and the
leading cause of chronic kidney disease is diabetes. And we
know how many people have diabetes, right, So a lot
(16:54):
of these patients come with us with hypertension. So that's
why we're so versed well versed in this. So patient
who are on one or two medications with uncontrolled blood
pressure usually come and see us. But people who at
see KD, who we see every day in the clinic,
they also usually have hypertension. So that's why we treat
all of them. So if somebody would like to reach
(17:16):
out to me for hypertension or their local kidney dock,
it would usually be after they've tried their one or
two medications that did not work and they could, you know,
call us in the big the big guns to come
in and help manage their blood pressure. But a lot
of this can be done in your primary care office too.
Speaker 1 (17:36):
Yeah, it's good to know. So it's really you're kind
of coming in, stepping into the picture once they once
the primary dock or the cardiologist whoever, is kind of
their wits end. They haven't realized, you know what, maybe
it's gotten to be.
Speaker 2 (17:50):
A little bit more.
Speaker 1 (17:51):
Maybe there's a different way of attacking this blood pressure.
So we're going to take a quick break here, but
I want to kind of go into a very new
area which doctor con actually introduced me to a very
new pathway in which docs now have at their disposal
to potentially attack blood pressure from a very new and
(18:12):
interesting angle. So quick break, you're on the hackers.
Speaker 4 (18:14):
You're listening to the medical hackers with doctor Sande Brow,
Board certified Vascular Interventionalist bringing you insights on treatments for
common medical problems on news radio six ninety KTSM. For
more information on the issues being discussed, or to contact
doctor Row, call nine one five five hundred four to
three seven zero or by emailing Rao at medical hackers
(18:38):
dot com.
Speaker 1 (18:42):
Back here on the Hackers, I'm doctor Row here with
a expert in the area of blood pressure and kidney disease,
doctor ukber Khon.
Speaker 2 (18:52):
Yes, Doctor Ow, good afternoon.
Speaker 1 (18:54):
So one of the things I wanted to get into,
and you mentioned this to me once when I was
visiting in your clinic, is you mentioned a new drug.
I was never aware of this. Basically it had just
come out and you have your finger on the pulse
of all things blood pressure, and this is a specific drug.
I don't want to get into the weeds on the
(19:16):
different pathways of controlling blood pressure. But there's this new
drug that we think that possibly the al dosterone pathway
is somehow involved. So a lot of patients have high
blood pressures that a lot of it's uncontrolled, but a
third of patients that have treatment resistant blood pressure. That
(19:36):
means one in three patients who have blood pressure that
your primary doc might have gone after there's actually a
new pathway in which we can control this blood pressure
and that's related to the the hormone, the aldosterone. So
really at a quick level, you know, aldosterone, how does
(19:58):
how does that work?
Speaker 4 (20:00):
Right?
Speaker 1 (20:00):
And I don't know, I don't know if people care
about the physiology here too much, but you know, it's
really about maintaining your your proper blood pressure. What is
al dostne's role in that? And how does this Why
is this new drug so important? Why were you so
excited to tell me about it?
Speaker 3 (20:19):
Yes, well, aldostrone is one of the most important homewarns
in our body. It helps regulate blood pressure, fluid balance
in the kidneys, and it works in the in the Yeah,
it works in the kidneys.
Speaker 2 (20:36):
Suh, Yeah, so what of course it works in the kidneys.
Speaker 3 (20:40):
So I'm still I'm so excited to talk about this
that I'm losing my words. So aldosterone has been been
researched for a long time, and you know, some of
this goes back to IU, which I there's a doctor
Myron Weinberger. He was the founder of the aldosterone assay.
(21:01):
We invented this at IU. It's a very big you.
Speaker 1 (21:04):
Can actually check your out so people can go and
check their aldosterol.
Speaker 3 (21:07):
So, yes, of course this is something. So maybe you've
heard of, I'm sure you've heard of, excuse me of
resistant hypertension. And this is when you're on multiple medications
and you're unable to achieve your BP goal.
Speaker 1 (21:20):
So real quick, So at what point would you want
to consider this new aldosterone drug. So the drug is
called larundro larunder stat Yes. And so when you say so,
let's say there's a patient out there that are listening,
maybe they've tried what's the first drug I think of
when I think of blood pressure control? Sometimes people try
like lasix or something, right, yeah, and then maybe you
might try maybe next to what's another drug?
Speaker 2 (21:43):
So maybe try?
Speaker 3 (21:44):
May I sure kindly correct you, doctor Row? The lasix is, yes,
a tool in our arsenal. But remember we are we're
very smart. We have so much research and data which
have been backed with you know, all the societies. We
have evidence based medicine. But if you were to start
your first blood pressure drug, it would easily be an
(22:07):
ACE or an ARB which is licina pro lo sartin.
These are this is a beta blocker. Okay, yes, all patients,
all the time, right, Yeah, it might.
Speaker 1 (22:16):
They're on the table, precedure table, and they say, this
patient has really have blood pressure and we have to
get it down immediately. I always go with the beta.
Speaker 2 (22:25):
That's stole, that's you're you're right, they are blood pressure medications.
But your beta blocker is good.
Speaker 4 (22:30):
Right.
Speaker 3 (22:31):
But remember, we have certain drugs that that are you know,
evidence based, we have data backing it up that decrease
mortality aka you know, save lives. So your first bet
is to always go after these drugs that we know
will make you live longer. Right, And we have a
handful of those. We have likecinapro, low sartine, the ACE
(22:52):
inhibitors we have, uh, we have, we do have the
beta blockers, the cardio selective ones like matopralow carved right.
So lay six, yes, is a good drug. But this
is an add on drug that we use, especially for
people who have extra fluid on them or if you
have heart failure. You know, that's a whole nother ballgame
that we're talking about. But for hypertension we use we
(23:16):
usually either start with an ACE or an ARB. Remember
that diabetes is so prevalent in our communities here in
the States that these This as well as lowering your
blood pressure, it also protects the kidneys and heart and
makes you live longer. So we have years of data
and trials backing this up, so we know the first
(23:36):
go to medicines to start your your blood pressure are
these drugs that we know decrease mortality. So you know,
each PA it's very individualized too. I mean we're generalizing here,
but remember each patient is different, and you know that's
how you're supposed to attack it. But there are there
are there's plenty of you know, information out there, and
you know, doctors know this, and that's why when you're
(23:57):
discussing this new drug coming out where it attacks all doostrone,
and we know all dostrone has many effects. It can
cause fibrosis on certain organs. You know, you may have
heard of a drug called spiral lacton, been around since
the fifties. This is a drug that has really good
for high blood pressure when other drugs don't work, but
it has side effects and spiral lactone can cause you know,
(24:20):
some side effects like a kind of camasity. It can
cause people to Yeah, ginocomasity is one off the top
of my head. So remember every every blood pressure drug
has these side effects that go with it, So choosing
the right profile for the right patient is extremely important.
And that just shows you know you're with the good
physician and doctor that's looking after you to make sure
(24:42):
that he identifies who you are, what things are specific
to you. So to answer your question, beta blocker is
a good choice. Yeah, so immediately, Yeah, for immediate control.
So this is the thing, but you're talking about longer
term control, yeah, which is really because hypertension high blood
pressure is a chronic disease. So I'm just looking at
(25:02):
it for how can I get someone's blood pressure down
in the next ten minutes.
Speaker 2 (25:07):
Okay, as long as it's not hydralazine. Don't get me
started on this drug. This is this is one that
I despise. Okay, hydrolysine.
Speaker 3 (25:14):
I just gave hydrolzy Okay, yeah, I don't want to
hear Okay, Okay, don't get me started after us. So,
hydralazine is a drug that is widely used. It's generic,
it's cheap as anything. They're like tic TACs.
Speaker 2 (25:28):
They give it a lot.
Speaker 3 (25:29):
And you know, in my training in my early days,
we used to give a lot of hydralazine until I
entered my nephrology fellowship. I don't want to scare the audience.
I bet many people aren't hydrolysine and it does have
some benefits. Yes, it doesn't save lives. It doesn't decrease
mortality like the other ones I was discussing. Hydrauzene has
some unwanted side effects rebound hypertension. You have to take
(25:50):
it three times a day. And when we get into
you know, kidney disease and some of these rare diseases,
it can cause diseases where people have to be admitted
and and go on special you know medications. There's something
called hydralazine induced vasculitis, and there's something called anka vasculitis.
Oh my, I'm getting to the weeds here. But I
(26:11):
actually call it hydrancazine. I won't even call it hydrolysine.
I despise this drug whoever. Yeah, but I know that
it's indicating some people. But there are so many options
out there. It's good to have a doctor where you're
able to discuss these, right like somebody like you know,
I'm sure your patients tell you what drugs are on
and you know, you're very intelligent, and you go through
(26:33):
your rolodex in your head and understand how some drugs
affect patients in certain ways. So it's okay that you
give hydrolysine, don't worry. Yeah, well it's not everyone, but
there are some bad things about it.
Speaker 1 (26:46):
Yeah. So I'm not doing it for chronic yeah, kidney disease.
I'm doing it for more an emergency where and so
it might have a different indication.
Speaker 2 (26:53):
I've given it so many times and I understand.
Speaker 4 (26:55):
Yeah.
Speaker 1 (26:56):
Yeah, so you know, we're kind of running against the clockier.
We've got a last couple of minutes. But I just
kind of want to close things out with this new drug.
So it sounds like this new drug or undershet just
looking at the study that I saw here in the
New Journal Medicine. Yes, it decreased blood pressure by about
twenty points, which is.
Speaker 2 (27:14):
I thought quite amazing, unbelievable.
Speaker 1 (27:15):
Yeah, So I guess the question is, at what point
would you consider introducing this new drug? Are you currently
is this a drug that is available readily available.
Speaker 2 (27:25):
Now or no, it's not. It's in the beginning stages.
Speaker 3 (27:28):
So I was at a major academic institution at IU,
and I was begging for this to be you know,
it's not out yet and remember pharmacy, pharmaceutical companies, all
that stuff is way more complex. But this study you
mentioned in the New England Journal came out in early
summer this year is a game changer, and you know,
(27:50):
maybe on another show, if you invite me back, we
can go into the whole study. But it's not out yet,
but it's promising and it attacks aldas, which can we
know helps and once it's available and once i mean
dropping by twenty points, it's unheard of, like you have
to take multiple medications for this to happen. So the
(28:11):
fact that this is even possible, it's great.
Speaker 1 (28:13):
Sure, So I'm definitely interested to hear about in the future. Unfortunately,
our time this Saturday is up. If you are interested
in any more about hearing more about any of these
mentioned treatments, you can always call to get more information
at nine one five five hundred forty three seventy five
zero zero four three seven zero. You can also reach
me by email at rawat medical hackers dot com. That's
(28:35):
my last name, Rao at medical hackers dot com. It
was great having doctor Kahn here on this show.
Speaker 2 (28:40):
Thank you.
Speaker 1 (28:41):
Great to also look forward to working with you in
the future because you're new to this city. I hope
these healthcare hacks have helped you navigate our complex medical system.
If you've been tuned into us this whole time, bless
your heart and your health. I'm doctor sand deep Row,
and you've been listening to the medical.
Speaker 5 (28:56):
Hackers pots stud a refecity, a discopism to the represented
by
Good afternoon. This is know the weekend here in the
heart of the dusty Chuaha Desert in West Texas. You're
listening to the Medical Hackers. However, you may be tuned
in this week and I'm your host, doctor Sandeep Raw.
We're here to bring the bordering of the latest information healthcare, medicine,
and technology on the show. I consider myself a hacker,
A hacker in the positive sense, A hacker used my
(00:26):
intimate knowledge of the medical system to helping breaking down
some of the bearish accessing new medical technologies and current
healthcare information. I have a fellow medical hacker here in me,
a fellow doctor. I don't have many guests on the show,
but I do have a guest doctor who.
Speaker 2 (00:46):
I recently met. He recently moved.
Speaker 1 (00:48):
To al Paso by way the Midwest, which is also
a little bit of my path here. I came here
from Ohio State. He came here from Indiana University. I
have doctor upper Khan. Good morning, you have your doctor
con So you're also by way of southern California. There
are a lot of There are a lot of Californians
I know I've seen moved to move to l Pass
and moved to this area. But I am interested to
(01:11):
know you are a nephrologist. You're a doctor of the kidneys.
I deal with the kidneys. You know, kidneys affect every
part of everybody's practice. For for me, you know, the
way kidneys affect me and my practice is we always
try to find out what patients renal function is before
I do a procedure, because some of the medications I
given a procedure affect the kidneys, can possibly impact the
(01:35):
renal function. But I'm actually just curious on a very
very high level, as a super specialized doc, a kidney doc.
You know, you you went through like myself. You obviously
went to med school for his med school, then you
did your careers of training as a internal medicine, then
you did your then you did your kidney fellowship. Right,
I'm curious, you know, how did you arrive to focus
(02:00):
on the kidneys, because there's so many different pathways as
the internal medicine doc, you can do. You could focus
on the kidneys, you can focus the heart, you could
do the lungs like like my dad did the lungs.
But I'm curious what drew you to the kidneys. It's
a very you know, it's a very different specialty.
Speaker 3 (02:15):
Yes, thank you, doctor Raw being a kidney doctor recently graduated,
the very kind words thank you.
Speaker 2 (02:24):
Yes.
Speaker 3 (02:25):
Going into nephrology, as we say, kidney medicine, first, you
have to go through internal medicine, which was my ultimate
favorite specialty given the giant area that it covers and
including lots of many different diseases and just taking care
(02:45):
of patients. In a sense, internal medicine is very broad
and once you enter internal medicine, then you have the
chance to either enter other subspecialties, either cardiology, gastroontrology, or nephrology.
The reason I chose nephrology was pretty sick simple, and
I go back to seeing my attendings in residency and
(03:05):
noticing how each attending had their unique flavor on how
to approach patients in the hospital. And with nephrology, I
noticed that my attendings were kind of different, almost normal.
So when I compared these two other doctors cardiologists, gastroentrologists, endocrinologist,
I noticed that these people just didn't align with what
(03:29):
I was going for, and nephrology appealed to me for
the normalcy. I had many attendings that I could relate
to on a personal level, family level, And so I
would say, because I noticed that they had normal lives,
they had time for their family, time for you know, activities,
and I couldn't see that myself and other specialties. So
(03:50):
if that's an answer, I guess because we're kind of normal.
Speaker 1 (03:54):
That it's a great answer because in a sense, a
lot of what drawss are in any pathway is being
able to identify ourselves or our future selves in that field.
So for me, I come from you know, people ask
me why am I a doctor in the first place,
not specifically vascular interventional radiology, but why my doctor? And
the thing is, there's so many docs in my family,
so I can easily see myself in that space. One
(04:17):
of my uh sort of friends is a musician, and like,
I could never see myself going to me into that,
but he said, you know, my dad was a musician,
my grand so so there's a lot of a lot
of mentors that guide you throughout, you know, your development,
your journey. And if you see somebody doing what you
could see yourself doing that job, I think that's kind
(04:38):
of what what brings you in. And so I think
I think good mentorship I think is in general is good.
So if there's anybody who listening out there who is
interested about medicine, I think, you know, finding docs or
find finding people who you can possibly relate to that
makes it a lot more easy to sort of to
get into. But you know, the thing about what I
like about the kidneys, To me, I feel like the
(04:59):
kidneys are are I don't know. Maybe you can correct
me if I'm wrong, because I don't think about this
too much. Okay, but obviously we have a we have
a brain. The brain controls our body. But to me,
the kidney to a certain degree, I feel like it's
like there's like this, you know, this control room in
like a warehouse, and there's some there's some genius, there's
kind of making sure everything is going right. Sure, you know,
there's so many moving parts in our body. There's so
(05:21):
many different parts of our body that the kidney impacts. Sure,
we have two kidneys. We could theoretically lose one. We
could donate your kidney, Yes you can. But I think
the kidney is such an important part of your body
because a lot of focus people focus on maybe you know,
heart disease. You know, if you were asked someone what's
the most important organ in the body.
Speaker 3 (05:42):
You know, I have I have an answer for you,
doctor Rout. So I I rank the body's organs. I
go the top three. Number one we got the brain,
Number two we got the heart, and number three is
the kidney. You know, I get a lot of flak
for that because I have the pominologists saying, hey, we
have two lungs too, and you have two kidneys or no.
(06:04):
I would always say, yeah, I have two kidneys. Of
course I'm going to be in the top three. And
I have my pumonologists chime in saying, you know, hello,
we got two of them.
Speaker 2 (06:12):
Two.
Speaker 3 (06:13):
The thing with kidney disease, with kidneys is that it's
our bodies are so complex. It's a beautiful thing. We
have some of the most complex anatomy physiology. What happens
with kidneys is that it's intertwined with everything. We have
hormonal feedback mechanisms, we have you know, whether it's blood pressure,
(06:34):
whether it's due to I can name a hundred of them. Kidneys, yes,
are very important, along with heart and brain and the lungs.
But the kidneys are unique because they are they are.
Speaker 2 (06:48):
The kidneys are unique. I wish I had a better answer.
It's like you, you gave me the alley you but
uh sure.
Speaker 3 (06:55):
What's unique about the kidneys, I would say, is that
it has to do with many things. Whether it's diabete,
whether it's hypertension, whether it's you know, you have osteoporosis.
There's all these different mechanisms that go through the kidneys
which make it a vital organ.
Speaker 1 (07:10):
And that's probably part of the reason why I specifically
did not want to be a nefrology. So to me,
I feel a nephrology is you have to really really
understand physiology. So when you're going through medical school, you know,
we take classes in anatomy, we take classes in a pathology,
in a you know, different field physiology, right, And so
(07:34):
for me, physiology is very complex and you have to
know that really well. You have to know how different
you know, enzymes, different hormones, things interact in your body.
And so for me, I actually enjoyed just the global
idea of, you know, the anatomic way of looking at
like that's what drew me into surgery initially and then
into vascuel or interventional that's where I'm doing procedures largely,
(07:56):
but nephrology is very much a thinking man's facility, you know,
thinking man's game there. So for me, I don't I
don't want to say that I'm not a thinker.
Speaker 2 (08:05):
You're very smart, doctor, I don't don't say that about
but I.
Speaker 1 (08:08):
Do enjoy working with my hands more and I think
that's what really makes nephrology very unique. It affects a
lot of parts of the body. There's a lot of
moving parts as we know, and there's so many interactions
that I don't think I was ever able to truly
truly grasp it. And that's what it's great to have
docs like you in this. So we're going to take
a quick little break here on the Hackers and I'm
(08:30):
going to come back with doctor kN here and we're
going to go into sort of what are the major
roles the kidney's play in the body, but specifically we
kind of want to do a little bit of a
dive into high blood pressure hypertension, which is really something
that there's some really interesting new developments in this area.
Speaker 4 (08:48):
So quick break here, you're listening to the Medical Hackers
with doctor Sandy Brow, board certified vascular interventionalist bringing you
insights on treatments for common medical problems on news radio
six ninety KTSM. For more information on the issues being discussed,
or to contact doctor Rao, call nine one five five
(09:08):
hundred four three seven zero or by emailing Rao at
medical hackers dot com.
Speaker 1 (09:17):
Back here on the Hackers, I'm doctor Rau here with
my special guest, doctor ukber Khan, and we've been initially
talking about his journey into the field of nephrology. But
one of the most important aspects that nephrologists have in
terms of a patient's disease processes is their role in
blood pressure, among many other things. Now, you know, we
(09:40):
look at blood pressure, Only twenty three percent of individuals
in the US with high blood pressure actually achieve their
treatment goals. So that means only one in four. So
if you're out there and you have high blood pressure,
find four other people with you who have high blood pressure,
only one in four of you actually will achieve the
(10:00):
goal that we, as a doc have set out for you.
And that's I think that's kind of a that's not
a great number. If I said, you know, our success
rate is like one in four, and so really there's
a lot of new treatments coming out. My particular interest
and I'm not going to get into this at all
on this show, is this area called the developing area
which we're trying to look at called renal denervation. That's
(10:21):
a procedural way and it's a cather based approach to
go after the nerves that sort of energize the kidney,
that get feedback from the kidney, the renal sympathetic nerves.
And it's a way to sort of get patients off
of these blood pressure medications or at least better control
them with blood pressure medications. I think it's difficult for
(10:44):
me to say get them off because I think all
patients are going to have to be on some pressure medication.
But really, high bloodresure is such an important role thin
in this in right, so it is the leading risk
factor for heart disease in the US and globally and
debth so so it's it's so important that people meet
their blood pressure goals. And so I guess a question
(11:07):
that I have for you, doctor, con Yes, blood pressure goal.
Your patient comes in very very high level, you know,
like you know what is what is their you know,
patient comes in at what point do you want to
a intervene and start giving them medications.
Speaker 3 (11:23):
Yes, that's a loaded question, doctor Rout. Hypertension extremely important,
as you are alluding to. It's the leading cause of
UH morbidity and mortality globally and in the United States
morbidity and mortality. People die with hypertension, and it's a
(11:43):
scary thing. I won't I won't beat around the bush.
It's not fun seeing young people going undiagnosed, not treating
themselves and ending up on the dreaded dialysis because of
hypertension and its downstream effects. When I see somebody with hypertension,
my main goal is first of all, identifying that it
(12:04):
is hypertension. We go through you know, we have very
detailed guidelines with you know, American Heart Association, the American
Society of Nephrology. There there are so many different guidelines
and societies that you know, you discuss hypertension. So when
we first diagnosed, we know that you have hypertension, which
is when a patient will be will be seen with
(12:26):
the blood pressure above one forty on two separate visits
within two weeks. You have to have this as your
official diagnosis. So just because you have one read at
the local Walmart and you're you know you're scared because
you think you have hypertension. Remember hypertension is officially diagnosed
two weeks. Wow, two different readings within two weeks at
(12:50):
different times, okay, And you know, just even getting the
right blood the accurate blood pressure is also important, which
I like to touch.
Speaker 2 (12:58):
You know.
Speaker 3 (12:59):
I see people with BP monitors on their wrist a
little FYI never use that people.
Speaker 2 (13:06):
The wrist BP monitor does not work.
Speaker 3 (13:10):
It's very inaccurate, and it's sad that we push this
sort of technology on all of our people to get
a good reading for blood pressure, which is actually interesting.
There's papers written on how to sit down and take.
Speaker 2 (13:23):
Your blood pressure. It would be at least.
Speaker 3 (13:26):
Five minutes or two to three minutes of not walking,
sitting in a chair. Your legs are not crossed, your
arms are by your side. It's on your upper arm,
the BP cuff. It has to fit right. There's certain
things you have to do to make sure you even
have high blood pressure. But once you are diagnosed with that,
the first thing we attack is what are you eating?
Speaker 2 (13:45):
What is your diet like?
Speaker 3 (13:46):
There's so many lifestyle changes that we put into medicine,
and this is the most important one. Blood pressure how
much salt you're taking, what's your diet, like fast food,
processed foods, all this sort of jazz that can go
into blood pressure. And once that's diagnosed, then you can
come to me as a kidney doctor, as a subspecialist,
and we take it a little further.
Speaker 2 (14:06):
So in that regard, just.
Speaker 3 (14:08):
Being diagnosed with high pertension alone is a big thing,
and you know, lifestyle changes is the first thing that.
Speaker 1 (14:14):
We go for sure. So there's a stat that I
have here. So out of the one hundred and twenty
million adults in the US, so that's about a third
of the US population actually who has high blood pressure,
three percent, as I said, have controlled pressure, which that
means they can get to their target of at least
target goals under a one point thirty over eighty, okay,
(14:36):
And forty five percent of any of these patients out
of these one hundred and twenty million adults, forty five
percent of these patients apparently have blood pressure readings above
one forty over ninety, which means, according to your thing,
maybe they should seek out a medical professional. So here's
my bigger question. There's so many docs who treat blood pressure.
(14:57):
Do you have your primary care doc so that maybe
they have a cardiologist. I don't know how many patients
have a nephrologist in their in their rolodex they need
to call upon. And so my question is, at what
point does it merit if a doc is listening to
the show, if a nurses listening to the show, or
if you're a patient listening to the show, at what
(15:19):
point should I call up, you know, pick up the
phone and say I need to see doctor Kahn. I
need to see a nephrologist to handle this. At this point,
you need to be step into the picture. What makes
nephrology you know, what brings you into the short?
Speaker 2 (15:33):
Yeah.
Speaker 3 (15:34):
When I entered my fellowship, it was Nephrology and Hypertension.
Speaker 2 (15:38):
I was a little intimidated. Wow the name of your phone.
Speaker 1 (15:40):
Yeah, oh so my pretension was part of the Oh yes,
I know. I didn't realize that. You know, it's kind
of interesting because I always think I associate high blood
pressure with cardiology. You never think of nephrology as a
front line.
Speaker 2 (15:53):
Well, thank you for not knowing that, doctor.
Speaker 3 (15:56):
Aw uh we Actually I recall having it on my
lab coat and I loved sporting that Nephrology and Hypertension
fellow you know in my training, and that is an
excellent question. Remember, medicine, like you know, doctor Rao is
includes all the specialties together. It's it's preventive. Like I
don't want I don't want to see you as a
(16:17):
patient for hypertension, then I know that something wasn't going down,
wasn't going correctly the other way. But we welcome all consults.
We want people to reach out to us for this.
Speaker 2 (16:26):
So for actual a patient to come see us. Let
me put it this way.
Speaker 3 (16:32):
So diabetes obesity, we know that hypertension is almost eighty
five to ninety percent. It's in patients who have diabetes
and chronic kidney disease. This is what you know our
bread and butter and nephrology, chronic kidney disease, and the
leading cause of chronic kidney disease is diabetes. And we
know how many people have diabetes, right, So a lot
(16:54):
of these patients come with us with hypertension. So that's
why we're so versed well versed in this. So patient
who are on one or two medications with uncontrolled blood
pressure usually come and see us. But people who at
see KD, who we see every day in the clinic,
they also usually have hypertension. So that's why we treat
all of them. So if somebody would like to reach
(17:16):
out to me for hypertension or their local kidney dock,
it would usually be after they've tried their one or
two medications that did not work and they could, you know,
call us in the big the big guns to come
in and help manage their blood pressure. But a lot
of this can be done in your primary care office too.
Speaker 1 (17:36):
Yeah, it's good to know. So it's really you're kind
of coming in, stepping into the picture once they once
the primary dock or the cardiologist whoever, is kind of
their wits end. They haven't realized, you know what, maybe
it's gotten to be.
Speaker 2 (17:50):
A little bit more.
Speaker 1 (17:51):
Maybe there's a different way of attacking this blood pressure.
So we're going to take a quick break here, but
I want to kind of go into a very new
area which doctor con actually introduced me to a very
new pathway in which docs now have at their disposal
to potentially attack blood pressure from a very new and
(18:12):
interesting angle. So quick break, you're on the hackers.
Speaker 4 (18:14):
You're listening to the medical hackers with doctor Sande Brow,
Board certified Vascular Interventionalist bringing you insights on treatments for
common medical problems on news radio six ninety KTSM. For
more information on the issues being discussed, or to contact
doctor Row, call nine one five five hundred four to
three seven zero or by emailing Rao at medical hackers
(18:38):
dot com.
Speaker 1 (18:42):
Back here on the Hackers, I'm doctor Row here with
a expert in the area of blood pressure and kidney disease,
doctor ukber Khon.
Speaker 2 (18:52):
Yes, Doctor Ow, good afternoon.
Speaker 1 (18:54):
So one of the things I wanted to get into,
and you mentioned this to me once when I was
visiting in your clinic, is you mentioned a new drug.
I was never aware of this. Basically it had just
come out and you have your finger on the pulse
of all things blood pressure, and this is a specific drug.
I don't want to get into the weeds on the
(19:16):
different pathways of controlling blood pressure. But there's this new
drug that we think that possibly the al dosterone pathway
is somehow involved. So a lot of patients have high
blood pressures that a lot of it's uncontrolled, but a
third of patients that have treatment resistant blood pressure. That
(19:36):
means one in three patients who have blood pressure that
your primary doc might have gone after there's actually a
new pathway in which we can control this blood pressure
and that's related to the the hormone, the aldosterone. So
really at a quick level, you know, aldosterone, how does
(19:58):
how does that work?
Speaker 4 (20:00):
Right?
Speaker 1 (20:00):
And I don't know, I don't know if people care
about the physiology here too much, but you know, it's
really about maintaining your your proper blood pressure. What is
al dostne's role in that? And how does this Why
is this new drug so important? Why were you so
excited to tell me about it?
Speaker 3 (20:19):
Yes, well, aldostrone is one of the most important homewarns
in our body. It helps regulate blood pressure, fluid balance
in the kidneys, and it works in the in the Yeah,
it works in the kidneys.
Speaker 2 (20:36):
Suh, Yeah, so what of course it works in the kidneys.
Speaker 3 (20:40):
So I'm still I'm so excited to talk about this
that I'm losing my words. So aldosterone has been been
researched for a long time, and you know, some of
this goes back to IU, which I there's a doctor
Myron Weinberger. He was the founder of the aldosterone assay.
(21:01):
We invented this at IU. It's a very big you.
Speaker 1 (21:04):
Can actually check your out so people can go and
check their aldosterol.
Speaker 3 (21:07):
So, yes, of course this is something. So maybe you've
heard of, I'm sure you've heard of, excuse me of
resistant hypertension. And this is when you're on multiple medications
and you're unable to achieve your BP goal.
Speaker 1 (21:20):
So real quick, So at what point would you want
to consider this new aldosterone drug. So the drug is
called larundro larunder stat Yes. And so when you say so,
let's say there's a patient out there that are listening,
maybe they've tried what's the first drug I think of
when I think of blood pressure control? Sometimes people try
like lasix or something, right, yeah, and then maybe you
might try maybe next to what's another drug?
Speaker 2 (21:43):
So maybe try?
Speaker 3 (21:44):
May I sure kindly correct you, doctor Row? The lasix is, yes,
a tool in our arsenal. But remember we are we're
very smart. We have so much research and data which
have been backed with you know, all the societies. We
have evidence based medicine. But if you were to start
your first blood pressure drug, it would easily be an
(22:07):
ACE or an ARB which is licina pro lo sartin.
These are this is a beta blocker. Okay, yes, all patients,
all the time, right, Yeah, it might.
Speaker 1 (22:16):
They're on the table, precedure table, and they say, this
patient has really have blood pressure and we have to
get it down immediately. I always go with the beta.
Speaker 2 (22:25):
That's stole, that's you're you're right, they are blood pressure medications.
But your beta blocker is good.
Speaker 4 (22:30):
Right.
Speaker 3 (22:31):
But remember, we have certain drugs that that are you know,
evidence based, we have data backing it up that decrease
mortality aka you know, save lives. So your first bet
is to always go after these drugs that we know
will make you live longer. Right, And we have a
handful of those. We have likecinapro, low sartine, the ACE
(22:52):
inhibitors we have, uh, we have, we do have the
beta blockers, the cardio selective ones like matopralow carved right.
So lay six, yes, is a good drug. But this
is an add on drug that we use, especially for
people who have extra fluid on them or if you
have heart failure. You know, that's a whole nother ballgame
that we're talking about. But for hypertension we use we
(23:16):
usually either start with an ACE or an ARB. Remember
that diabetes is so prevalent in our communities here in
the States that these This as well as lowering your
blood pressure, it also protects the kidneys and heart and
makes you live longer. So we have years of data
and trials backing this up, so we know the first
(23:36):
go to medicines to start your your blood pressure are
these drugs that we know decrease mortality. So you know,
each PA it's very individualized too. I mean we're generalizing here,
but remember each patient is different, and you know that's
how you're supposed to attack it. But there are there
are there's plenty of you know, information out there, and
you know, doctors know this, and that's why when you're
(23:57):
discussing this new drug coming out where it attacks all doostrone,
and we know all dostrone has many effects. It can
cause fibrosis on certain organs. You know, you may have
heard of a drug called spiral lacton, been around since
the fifties. This is a drug that has really good
for high blood pressure when other drugs don't work, but
it has side effects and spiral lactone can cause you know,
(24:20):
some side effects like a kind of camasity. It can
cause people to Yeah, ginocomasity is one off the top
of my head. So remember every every blood pressure drug
has these side effects that go with it, So choosing
the right profile for the right patient is extremely important.
And that just shows you know you're with the good
physician and doctor that's looking after you to make sure
(24:42):
that he identifies who you are, what things are specific
to you. So to answer your question, beta blocker is
a good choice. Yeah, so immediately, Yeah, for immediate control.
So this is the thing, but you're talking about longer
term control, yeah, which is really because hypertension high blood
pressure is a chronic disease. So I'm just looking at
(25:02):
it for how can I get someone's blood pressure down
in the next ten minutes.
Speaker 2 (25:07):
Okay, as long as it's not hydralazine. Don't get me
started on this drug. This is this is one that
I despise. Okay, hydrolysine.
Speaker 3 (25:14):
I just gave hydrolzy Okay, yeah, I don't want to
hear Okay, Okay, don't get me started after us. So,
hydralazine is a drug that is widely used. It's generic,
it's cheap as anything. They're like tic TACs.
Speaker 2 (25:28):
They give it a lot.
Speaker 3 (25:29):
And you know, in my training in my early days,
we used to give a lot of hydralazine until I
entered my nephrology fellowship. I don't want to scare the audience.
I bet many people aren't hydrolysine and it does have
some benefits. Yes, it doesn't save lives. It doesn't decrease
mortality like the other ones I was discussing. Hydrauzene has
some unwanted side effects rebound hypertension. You have to take
(25:50):
it three times a day. And when we get into
you know, kidney disease and some of these rare diseases,
it can cause diseases where people have to be admitted
and and go on special you know medications. There's something
called hydralazine induced vasculitis, and there's something called anka vasculitis.
Oh my, I'm getting to the weeds here. But I
(26:11):
actually call it hydrancazine. I won't even call it hydrolysine.
I despise this drug whoever. Yeah, but I know that
it's indicating some people. But there are so many options
out there. It's good to have a doctor where you're
able to discuss these, right like somebody like you know,
I'm sure your patients tell you what drugs are on
and you know, you're very intelligent, and you go through
(26:33):
your rolodex in your head and understand how some drugs
affect patients in certain ways. So it's okay that you
give hydrolysine, don't worry. Yeah, well it's not everyone, but
there are some bad things about it.
Speaker 1 (26:46):
Yeah. So I'm not doing it for chronic yeah, kidney disease.
I'm doing it for more an emergency where and so
it might have a different indication.
Speaker 2 (26:53):
I've given it so many times and I understand.
Speaker 4 (26:55):
Yeah.
Speaker 1 (26:56):
Yeah, so you know, we're kind of running against the clockier.
We've got a last couple of minutes. But I just
kind of want to close things out with this new drug.
So it sounds like this new drug or undershet just
looking at the study that I saw here in the
New Journal Medicine. Yes, it decreased blood pressure by about
twenty points, which is.
Speaker 2 (27:14):
I thought quite amazing, unbelievable.
Speaker 1 (27:15):
Yeah, So I guess the question is, at what point
would you consider introducing this new drug? Are you currently
is this a drug that is available readily available.
Speaker 2 (27:25):
Now or no, it's not. It's in the beginning stages.
Speaker 3 (27:28):
So I was at a major academic institution at IU,
and I was begging for this to be you know,
it's not out yet and remember pharmacy, pharmaceutical companies, all
that stuff is way more complex. But this study you
mentioned in the New England Journal came out in early
summer this year is a game changer, and you know,
(27:50):
maybe on another show, if you invite me back, we
can go into the whole study. But it's not out yet,
but it's promising and it attacks aldas, which can we
know helps and once it's available and once i mean
dropping by twenty points, it's unheard of, like you have
to take multiple medications for this to happen. So the
(28:11):
fact that this is even possible, it's great.
Speaker 1 (28:13):
Sure, So I'm definitely interested to hear about in the future. Unfortunately,
our time this Saturday is up. If you are interested
in any more about hearing more about any of these
mentioned treatments, you can always call to get more information
at nine one five five hundred forty three seventy five
zero zero four three seven zero. You can also reach
me by email at rawat medical hackers dot com. That's
(28:35):
my last name, Rao at medical hackers dot com. It
was great having doctor Kahn here on this show.
Speaker 2 (28:40):
Thank you.
Speaker 1 (28:41):
Great to also look forward to working with you in
the future because you're new to this city. I hope
these healthcare hacks have helped you navigate our complex medical system.
If you've been tuned into us this whole time, bless
your heart and your health. I'm doctor sand deep Row,
and you've been listening to the medical.
Speaker 5 (28:56):
Hackers pots stud a refecity, a discopism to the represented
by
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
The Clay Travis and Buck Sexton Show
The Clay Travis and Buck Sexton Show. Clay Travis and Buck Sexton tackle the biggest stories in news, politics and current events with intelligence and humor. From the border crisis, to the madness of cancel culture and far-left missteps, Clay and Buck guide listeners through the latest headlines and hot topics with fun and entertaining conversations and opinions.