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Renown Health, the region's leading cardiology care provider, is offering a clinical trial for eligible patients struggling to control their high blood pressure. Nearly half of adults (119.9 million) in the United States have hypertension, or blood pressure that is higher than normal. Hypertension can put you at risk of other life-threatening disease, such as a heart attack or stroke. There are methods that cardiologists use to manage high blood pressure, but only 1 in 4 adults with hypertension (27.0 million) have their blood pressure under control.* Some patients with high blood pressure experience resistant hypertension, which does not respond well to multiple antihypertensive medications given at the same time. This means that there are many important opportunities for healthcare professionals to explore new ways to treat hypertension.  At Renown Health, we lead the region in cardiology care with our technological expertise and patient-centered approach. That is why our cardiology team is partnering with the Renown Research Office to offer the RADIANCE Continued Access Protocol (RADIENCE CAP) clinical trial to eligible patients. RADIANCE CAP is a non-randomized study designed to allow for continued access to ultrasound renal denervation therapy via the Paradise System, and to allow for the on-going collection of safety and effectiveness data in patients with uncontrolled hypertension despite the prescription of antihypertensive medications. The body’s complex communication system between the brain, heart and kidneys can sometimes become overactive, increasing your blood pressure through messages in the nervous system. Renal denervation is a minimally-invasive procedure which reduces activity from the nerves in your kidneys to lower blood pressure.  This is the third in a series of renal denervation clinical trials Renown Health has offered to patients with resistant hypertension over the last several years, with over 40 local participants.  “All the participants that I have had the pleasure to work with on these studies are very excited and grateful to have this option for helping control their blood pressure” states Lisa English, Lead Clinical Research Coordinator for Cardiology studies at Renown Health. “I love getting to know each one of them and helping on their healthcare journey. We have an amazing team of providers and staff at Renown that go out of their way to make patients experiences positive and the studies successful.” Dr. Michael Bloch, Cardiologist and Principal Investigator for the RADIANCE CAP study at Renown Health’s Institute for Heart and Vascular Health adds, “Despite lifestyle modifications like diet and exercise and the widespread availability of effective and well-tolerated medications, approximately 50% of all people with hypertension have inadequate blood pressure control putting them at risk for stroke, heart failure and kidney disease. As a one-time durable procedure, renal denervation with the Paradise endovascular system from ReCor Medical, Inc. may help millions of patients improve their blood pressure control without necessarily needing to increase their medications.” Our teams of expert providers and researchers are here to support you on your healthcare journey. Talk to your provider about the RADIANCE CAP clinical trial at your next appointment to see if participation may be right for you.

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In February, we think about hearts not just in honor of Valentine’s Day but because it is American Heart Association Month. This is a great reminder to focus on our personal cardiovascular health. Renown Health helps patients think about their heart health with our world-class providers and cutting-edge treatments through our Cardiovascular Clinical Trials. “Research serves a vital role in the future care of cardiovascular diseases. Being involved in research will help our medical community to further discover new treatment plans in our quest for life preservation and extension,” Dr. Thomas To, Cardiologist and Researcher at Renown Health. For example, let’s talk about atherosclerosis. When our hearts are healthy, they are a strong muscle that pumps our oxygen-rich blood through our coronary arteries. Over time, cholesterol and fats can build up in our arteries. This is a condition known as atherosclerosis. This type of plaque buildup in the arteries can lead to a heart attack or stroke if not properly managed. If you are experiencing chest pain or discomfort, shortness of breath or pain in areas of the upper body, these can be the warning signs of a heart attack, and you should call 911. One contributing factor to atherosclerosis is elevated lipoprotein(a) levels and the accumulation of cholesterol in the arteries, which increases the likelihood of a heart attack or stroke. Lipoprotein(a) is tested separately from the standard panel that is completed for cholesterol management, and while your total cholesterol levels may be in a healthy range, lipoprotein(a) levels can still be elevated. "Increasingly we are realizing that lipoprotein(a) levels can be used as an important assessment in more carefully delineating an individual's risk of future cardiovascular events and treatment targets" said Dr. Michael Bloch, Lipid Specialist and Researcher at Renown Institute for Heart and Vascular Health. While it is clear that elevated lipoprotein(a) contributes to atherosclerosis, there are currently no approved medications for reducing cardiovascular disease risk through reducing lipoprotein(a) levels. This is why Renown Health’s Research Office is proud to offer a phase III clinical trial, called the OCEAN(a) study, to our patients with elevated lipoprotein(a) levels as a care option for management of their heart disease risk. Our teams of expert providers and researchers are here to support you on your healthcare journey. “I am thrilled to be able to be part of this study and bring opportunities like this to our patients. The highlight of my day is getting to hear life stories from my patients during our study visits,” Lisa Preciado, Primary Clinical Research Coordinator for the OCEAN(a) study said. Join us in raising awareness around American Heart Month by talking to your provider about lipoprotein(a) at your next appointment. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.

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Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

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With more than 29 million adult Americans having high cholesterol, it’s important to know the facts. We asked Jayson Morgan, MD, a cardiologist with Renown Institute for Heart and Vascular Health, explains the numbers, the risk factors and how to maintain healthy levels. What is cholesterol? There are two types: Low-density lipoprotein (LDL) cholesterol, also known as the “bad” variety, because it can eventually build up within the walls of your blood vessels and narrow the passageways. High-density lipoprotein (HDL), also known as the “good” variety, because it helps remove other forms of cholesterol from the bloodstream. In adults, total cholesterol is considered high if it is more than 200 mg/dL. If the total is more than 200 or if high-density lipoprotein (HDL) levels are less than 40, your heart and brain may not be getting as much oxygen-rich blood as they need. This puts you at greater risk of heart attack and stroke. HDL levels greater than 60 mg/dL can actually lower your risk. What are the risk factors for high levels? Diet high in saturated fat Excess body weight Lack of exercise Smoking Family history Age (as people age, they are more prone to high levels) How often should someone get their numbers checked, and what kind of test is done? The American Heart Association recommends all adults age 20 or older have their cholesterol checked every four to six years. Those with cardiovascular disease or who are at higher risk of it may need their levels and other risk factors assessed more often. Your primary care provider can perform the test, along with assessing your other risk factors to help determine a treatment plan if necessary. The test will likely be one you will need to fast for, meaning no food, beverages or medications for around nine to 12 hours. Your healthcare provider will let you know if, and for how long, to fast. A simple blood test is all that’s needed to get your levels. What are some ways to lower “bad” cholesterol and raise “good” cholesterol? To achieve healthier levels, people should: Eat a heart-healthy diet: Choose healthier fats, eliminate trans fats, eat foods rich in omega-3 fatty acids and increase soluble fiber. Increase physical activity: Exercise on most days of the week. Quit smoking: If you smoke, it’s time to stop. Quitting smoking will improve HDL “good” cholesterol levels. Lose weight: Losing as little as five to 10 percent of your weight can improve cholesterol levels. Drink alcohol only in moderation. And finally, if lifestyle changes aren’t enough, your care provider might recommend medication to help lower your numbers. Renown Institute for Heart & Vascular Health For optimal heart health, the American Heart Association encourages you to “Know Your Numbers” which include: blood pressure, body mass index (BMI), cholesterol and fasting blood sugar, by scheduling a visit with your doctor. These numbers are critical in assessing your current risk for heart disease and stroke. Find a Cardiologist

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Maintaining a healthy weight has many benefits: among those is improved heart health. If you’re trying to eat right as well as become healthier, nutrition experts say you might want to consider a plant-based diet. Plants provide air to breathe, beauty in our surroundings — and just may be a viable solution to your weight-loss goals. According to the Centers for Disease Control and Prevention, more Americans than ever are overweight: Today, 7 in 10 Americans are classified as “obese” or “overweight,” and childhood obesity rates are growing rapidly. So experts encourage would-be dieters to look to plants as a source of daily inspiration. “When you slowly and consistently expand your daily food choices to include more plant-based options, you will feel fuller, have more energy and lose weight,” says Lynice Anderson, director of Renown’s Healthy Heart Program. But according to a recent study from the U.S. Centers for Disease Control and Prevention, just 1 in 10 adults eats enough vegetables and only 12 percent get the recommended amount of fruit daily. The same study notes that eating a diet rich in fruits and vegetables daily can help reduce the risk of many leading causes of illness and death, including heart disease, type 2 diabetes, some cancers and obesity. Plant Foods = Foods with Fiber One of the overwhelming health benefits of plant-based foods: fiber. A study published in a recent issue of the Annals of Internal Medicine suggests that something as simple as aiming to eat 30 grams of fiber each day can help you lose weight, lower your blood pressure and improve your body’s response to insulin just as effectively as a more complicated diet. Fiber contains no calories and comes in two forms: soluble, which dissolves in water, and insoluble, which doesn’t dissolve. Both are important for different reasons. The soluble fiber found in oats, fruits and beans forms a gel-like substance and helps to lower blood cholesterol and blood sugar levels. Insoluble fiber found in fruit skins, green beans and cauliflower goes through your intestines relatively intact providing “bulk” and improving bowel-related health problems. “My fiber champion is chickpeas, also known as garbanzo beans,” says Renown Chef Chris Wyatt. “They are high in fiber, low in fat, low sodium and have zero cholesterol. Not only do they not contain any cholesterol, chickpeas work to remove cholesterol from your body. It’s a win-win.” Snacks That Are Part of a Plant-Based Diet Looking for the best sources of fiber from the plants and trees in your life? Here are the best options, according to this CDC fact sheet: Fruits Raspberries, 1 cup: 8.0 grams of fiber Pear, with skin, 1 medium: 5.5 grams of fiber Apple, with skin, 1 medium: 4.4 grams of fiber Strawberries (halved), 1 1⁄4 cup: 3.8 grams of fiber Banana, 1 medium: 3.1 grams of fiber Orange, 1 medium: 3.1 grams of fiber Veggies Artichoke, cooked, 1 medium: 10.3 grams of fiber Peas, cooked, 1 cup: 8.8 grams of fiber Broccoli, boiled, 1 cup: 5.1 grams of fiber Turnip greens, boiled, 1 cup: 5.0 grams of fiber Sweet corn, cooked, 1 cup: 4.2 grams of fiber Brussels sprouts, cooked, 1 cup: 4.1 grams of fiber Potato; with skin, baked, 1 medium: 2.9 grams of fiber Carrot, raw, 1 medium: 1.7 grams of fiber Renown Health Improvement Programs | Appointments: 775-982-5073  Renown Health offers a number of educational and support programs to help people overcome the challenges presented through various health conditions and to aid in creating and adopting a healthy lifestyle. To get an assessment of your dietary needs, schedule a consultation with one of Renown’s registered dietitians, who can help with: Diabetes Programs Medical Weight Management Nutrition Programs Make an Appointment

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