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Managing and Treating Hypertension with Dr. Jay Shah

George Grombacher July 21, 2023

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Managing and Treating Hypertension with Dr. Jay Shah

LifeBlood: We talked about managing and treating hypertension, the most common chronic disease afflicting over a billion people, and the technology changing how we monitor it, with Dr. Jay Shah, Chief Medical Officer of Aktiia.      

Listen to learn why and how we’ve grown complacent about high blood pressure!

You can learn more about Dr. Jay at Aktiia.com, Facebook, Twitter, Instagram, YouTube and LinkedIn.

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Our Guests

George Grombacher

Dr. Jay Shah

Episode Transcript

Dr. Jay Shah 0:01
Well, Blood This is George G. And

george grombacher 0:03
the time is right welcome today’s guest strung apart for Dr. J. Shaw, J. Are you ready to do this?

Dr. Jay Shah 0:08
Sounds great. Glad to be here. Thanks for having me.

george grombacher 0:10
excited to have you on let’s go. Dr. J is chief medical officer with Actaea their cuffless Blood Pressure devices software platform, changing how we diagnose, treat, and manage hypertension. Jay excited to have you on tell us a little bit your personal life smart about your work and why you do

Dr. Jay Shah 0:27
what you do. Thanks very much. I’m personal life. Father, I’ve got two children. We are moving to Boston and excited about that. I am a cardiologist by training, I’ve been practice for over 15 years, I trained at Massachusetts General Hospital as the Boston connection, and did my cardiology training in St. Louis at Washington University. And then I started my own practice from scratch in Portland, Oregon, and ran that for seven years. And then about four years ago, got an opportunity to join the Mayo Clinic, which I did in their Arizona practice, and started the their clinic for complex thoracic aortic diseases. And after about 12 years or so, in practice, I started, you know, really wondering, you know, where I could have maybe a different way to take that clinical expertise and have a broader impact on people at large. And rather than just one patient at a time. And that led me on sort of a process of discovery, and eventually to this company Actaea, where I have been the Chief Medical Officer for now, almost two years. But that’s kind of my background in a nutshell. I love

george grombacher 1:44
it. Nice. And did you grow up in Boston? Jay,

Dr. Jay Shah 1:48
I grew up in St. Louis. So I’m a Midwestern kid. But I did my college in the Midwest and medical school, but ended up in Boston for residency. And it’s where I met my wife. And so that’s that’s our ties to the northeast, and she’s from the Northeast as well. Got it. Okay.

george grombacher 2:05
Well, you got the Pacific Northwest, you got the southwest?

Dr. Jay Shah 2:08
I know, I’ve covered most of the country. I think that that’s awesome.

george grombacher 2:12
So I don’t know, what is how do you spend your time as a chief medical officer now versus I sort of understood what you were doing with the male?

Dr. Jay Shah 2:24
Right? Yeah. So instead of I mean, for 15 years, I’ve been in clinic in the hospital seeing patients one at a time. And as chief medical officer, it’s kind of a interesting role, I find it super interesting is it the company as a whole, and we’ll talk about what our sort of overall mission is, is to really optimize and and help people control hypertension, which is the world’s most common chronic disease, and the most common modifiable cause of death in the world. And but in that, in this role, I kind of work in across multiple functions. And I get to work in the research and development phase of the company regulatory phase as part of the company, the product development, and as well, the commercialization or business development of bringing the product to market. So across all these different functions of the company, I serve as the primary met primary medical voice, clinical voice, and sort of really help the help the company kind of maintain focus on the end customer, which is going to be me, you anyone, a patient’s really and so that’s it’s really critical that we have the, you know, the medical perspective and point of view. Yeah, for

george grombacher 3:41
sure. I think that that’s very cool. And I imagine that you’re a curious person, and obviously an intelligent person. So to get to just take on a new challenge is I that certainly makes sense to me.

Dr. Jay Shah 3:55
Yeah, thanks very much. Now, I It has been a great shift, I guess, in my career. It’s vastly different from what I’ve been used to doing. But I’m learning a ton. And I really enjoy the people I’m working with and the team, so I couldn’t be happier.

george grombacher 4:10
Nice. So hypertension, you said it was the most common chronic disease and also the most influenceable. Thanks, something along those lines. Tell me more about hypertension.

Dr. Jay Shah 4:20
Yeah, so hypertension, most people are aware of what hypertension is high blood pressure, right? hypertension, high blood pressure, people are kind of very aware of that problem, but may not be aware of how serious it is, and how widespread so it’s 1.4 billion people in the world have hypertension. 130 million Americans have hypertension. It is by far the most common modifiable cause of death in the world, per the who. So it’s an extremely common problem. And almost everyone has heard of it. Everyone sort of probably has some sense that high blood pressure is bad and it can affect your heart and these kinds of things. But it’s often not talked about or even by the medical community with sort of an urgency or, or real push that it needs, that we need to do something about it other than, you know, control it, get it under control at some point, it’s a risk factor. So sort of breeds a level of complacency, I think, among many people. But the truth is, is that it is so fundamentally important to so many different organ systems. And it is the primary input into the main causes of death and disease in the world with namely, heart disease. Stroke, even has a significant influence over cognitive impairment and dementia, kidney disease, aortic aneurysms, reproductive health, on and on, it has, it has tremendous secondary effects. So, you know, it, I think it’s sometimes sort of under the radar. And on top of that, even though it’s so common, people that you don’t feel it, there are no symptoms with high blood pressure. So it doesn’t give people the same sort of urgency or annoyance as your knee or your hip or your back or some other sim, you know, physical symptom that reminds you every day, hey, there’s some problem here. There is nothing like that in high high blood pressure, and it can exist and often does, for decades, causing its damage without anyone ever knowing about it.

george grombacher 6:29
Or easy. 1.4 billion people 130 million Americans. And that were mildly complacent about it. I think that that’s it’s it’s, it’s it’s kind of wild when you think about it. So when I think I don’t know much about high blood pressure, I guess I’m fortunate that I’m not one of those people. And hopefully I never will be what is really happening. Is that mean that? Yeah, instead of me trying to describe it all just at

Dr. Jay Shah 6:55
night. And I think that sometimes the statistics and the common commonality of the problem, in actually make the complacency worse, because everyone just sort of assumes that, okay, it’s out there, I may get it. But if I do, so many people have it, I’m sure they’re all fine. And even if you know, you don’t have it, or I don’t get it, hopefully, one in two people over the age of 65 will so even if you don’t chances are one of your loved ones, your mom, dad, brothers, sisters, spouse, somebody’s going to get it that that you know, and and or even if you don’t know that they necessarily have high blood pressure, they’ll get something else, they’ll have dementia, they’ll have cognitive to have a stroke, they have a heart attack, all of those things largely are driven, in part by high blood pressure. So how does it actually cause these problems? Well, hypertension, or high blood pressure by itself is a disease of the vessels of the body where you get higher pressure in all the arteries of your body. You can’t feel it, there are no nerve endings on the inside of your arteries. But but the pressure is there and it’s higher overall over the long period of time, decades, years, decades over time. And your underlying Oregon’s your brain, your eyes, your heart, your kidneys are all exposed over time to this higher than normal pressure. And they’re not designed for that. They’re not designed to withstand that higher pressure of blood coming into those vessels. So over time, that higher pressure leads to chronic damage of the tiny, tiny, tiny vessels that no one can see in your brain, your heart, your eyes, your kidneys, etc. And therefore it leads to problems like stroke, aneurysms, dementia, vision loss, kidney failure, heart failure, heart attack, a arrhythmias aortic aneurysm, one after another after another. So that’s how it causes its problems. And it does it silently. It does it slowly. And it does it over a long period of time.

george grombacher 9:03
All right. So enter Actaea How are how is how, tell us tell us what what you’re actually doing?

Dr. Jay Shah 9:11
Sure. So Actaea was founded by two Swiss biomedical engineers. And they were really are really experts at optical signal processing. So the novel technology at the heart of Actaea is their invention of being able to with an optical, of with an LED light and an optical signal worn on with a device on the wrist. They’re able to capture these optical signals of blood flowing through the capillaries of your small vessels of your skin, analyze those signals and deliver back accurately, blood pressure and heart rate. And they do and it does it without you knowing that it’s taking measurements and it does it consistently and continually over time. So think about 25 to 30 readings a day. Couple 100 A week Make 800 to 1000 a month, and you don’t have to do anything, you don’t have to sit in a position, you don’t have to, you know, be very still, you can just live your life and it’ll track and up, you know, monitor and track and make sure your blood pressure routinely over time. And that’s one of the aspects of blood pressure. That is sort of, there’s a fallacy because of the traditional cuffs that everyone is pretty well aware of how to take a blood, you get one measurement at one point in time, but you don’t really know what’s happening the rest of the time. And that’s one of the keys of high blood pressure that is continuously changing. So even if you get one measurement, and it looks good, you could still for 23 hours a day, and arm and more have out of range, you know, blood pressure that’s out of an optimal range. So taking many frequent measurements over time is the only realistic way to really have a full picture of your blood pressure. And then around that innovative technology, the software around it starts to help people individualize their understanding of their blood pressure pattern, and what can they do to improve it, empowering them, and really putting them in control of a chronic disease, where they were people, individuals patients, are the ones who are the most, you know, the ones who, who need to take charge the most, because physicians, you know, medical practitioners will see people once a year, once every six months, 1520 minutes, but the large in the vast amount of time, majority of time, 364 days, 23 hours and 45 minutes, you know, that’s it’s really up to the patient to really take charge of their own health. And the software is designed to help them do that. And it’s all about patient empowerment.

george grombacher 11:57
Well, I love it. Amen to that. It makes sense. I’ve never thought about you know, you go and you sit down in the doctor’s office, it puts the cuff on you it gets tight gives you the reading, like I have no idea what’s what’s what’s what’s going on, what’s kind of good or bad. Do I have a resting blood pressure? And then it goes up and down? Or is it not like my heart rate or all

Dr. Jay Shah 12:18
it’s it’s, it’s just No, it’s not similar to your heart rate, although there there is a sort of fluctuation to it. But there’s so there’s a fluctuation when you’re resting versus when you’re exercising versus when you recover from exercise. But there’s also fluctuations between morning, afternoon, evening, nighttime sleep waking up. And so there’s there’s a complex pattern, it’s not just like a heart rate of like resting, you know, not resting, it’s not like that. So it’s a complex pattern, that that really is unknown to most people, because who really takes their blood pressure every 10 minutes, for 24 hours or weeks at a time to really understand what that pattern is, don’t do that it’s not possible in with vast majority of things. And so, so this is the, for the first time, we’re able to compile a data set for each individual, where we get this highly complex data set that that where we can start to discover the signals and insights that are hidden, hidden in those patterns.

george grombacher 13:24
So interventions, I, my guess is that if I am overweight, if I have, so my physical composition, probably somebody with my blood pressure, but then also, if I’m in a stressful environment, and then I can look and see oh my gosh, look at four o’clock in the afternoon, my blood pressure was really, really high what was going on, then?

Dr. Jay Shah 13:47
The first thing to kind of understand about interventions is to understand that blood pressure, as we talked about, really does its damage over time. So what is important are perspective at Actaea. And really, physiologically it makes sense. That one reading at one time or one hour a day of one specific day actually means very little in the long run what you really care about our weeks, months, years of patterns and trends. And so really that’s sort of the lens we should be looking at and thinking about blood pressure. But to your point of Okay, so let’s say somebody’s blood pressure over a longer period time is high, and what do they do about it? But one of the things that we you mentioned a few that are that are right, and almost all of us could rattle off a few common things that what do you do when your blood pressure’s high? Oh, well, we probably should exercise more fresh to lose weight, reduce sodium, reduce alcohol, stop smoking. The common things that everyone almost everyone could probably think of. What we don’t know is how does a specific intervention affect a specific individual? So how do I know George Will Whether you personally would benefit from sodium reduction, I have no as a clinician, I have no idea. So we make the same recommendation to every single person who has high blood pressure, irrespective of that person and that individual. And we know, just as an example, salt reduction, okay, everyone thinks about that it’s very difficult to do. But everyone, all physicians and healthcare providers recommend sodium reduction to people who are hypertensive, but only 50% of hypertensive people are salt sensitive. Meaning that only half of the people who, even if they actually tried sodium reduction, would actually have a significant response in their blood pressure for the other half. It’s kind of a waste of time. And we have no idea who’s who. So one of the aspects of our software that we’re designing is, or, again, around this innovative technologies to figure out who responds to which intervention. And how good is that intervention for that one person. So for example, if we do dry January, some people lack of alcohol makes very little difference, their blood pressure, others, it might make a significant difference. We don’t really know who’s who’s which. But with our technology and the software that we build around it, we can start to identify those individual patterns and start to personalize the recommendations for the first time really in hypertension.

george grombacher 16:31
I think that’s it. I think it’s exciting. And, and, and pretty incredible. So how is it going so far? It’s going well,

Dr. Jay Shah 16:43
it’s going really well, you know, we are in the European market. So we have approval have been in the European market for two years, we have over 40,000 users, we have a number of hospitals and clinics that are now deploying the technology across their patient populations. So that part’s going really well, we are working to get it to the US market. And obviously, it’s a regulated medical device. So that has to go through the FDA. It’s a long and arduous process. But we’re confident that we’ll get through at some point. So there are certainly challenges in regulated medical device, you know, world but, but the but the but what we have demonstrated is that for the users who have tried it in the markets we are in there’s significant interest and traction. So we’ll continue to refine our product and make sure that we obviously listened to patients and to healthcare providers, and to really build it for them, because they in the end, that’s that’s why we’re here.

george grombacher 17:43
Well, Jay, thank you so much for your work. And thank you so much for coming on. Where can people learn more about you? And where can they learn more about Actaea?

Dr. Jay Shah 17:52
Well, thanks for having me on, you can go to our website at any time www.actaea.com aktia.com All our social media sites are at Actaea global, you can certainly find me on LinkedIn, as well. And yeah, and you can sign up on the website, especially in the US there’s a email list for all if you’re interested for to get updates as we as we get closer to the US market and just updates in general.

george grombacher 18:23
Excellent. Well, if you enjoyed as much as I did, show Dr. J, your appreciation and share today’s show with a friend who also appreciates good ideas go to actaea.com It’s a que TI a.com You can find them on social media at Actaea global and then find Dr. J Shaw, J ys, H A H on Linked in and if this is of interest to you, if you’re somebody who is suffering from hypertension or dealing with it, or do you have a loved one, absolutely get on that distribution list that Jay was talking about and stay up to date for when it is approved and launches here stateside. Thanks again, Jay.

Dr. Jay Shah 19:03
Sounds good. Thank you very much.

george grombacher 19:05
And until next time, remember, do your part by doing your best

Transcribed by https://otter.ai

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