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Nurse Practitioner Becomes First Advanced Practice Clinician with Certification in Hypertension

Baptist Health Medical Group Cardiology began a certified hypertension program for patients with treatment-resistant hypertension

Kristy Salley, APRN, CVNP-BC, CHC, with Baptist Health Medical Group Cardiology, is a certified hypertension clinician and nurse practitioner.

LEXINGTON A CDC report from the Behavioral Risk Factor Surveillance System in 2021 said that almost 40% of Kentuckians reported that they had high blood pressure. The national average in the U.S. is 32.4%. The same study said that the state with the highest percentage of individuals reporting with high blood pressure was Mississippi, with 43.9%. The state with the lowest population with high blood pressure was Colorado, with 26%.

Treating patients with refractory, or treatment-resistant, hypertension has been the goal of Kristy Salley, APRN, CVNP-BC, CHC, since she received advanced training as a certified hypertension clinician in 2021.

Salley recently obtained additional training and education through the American Board of Cardiovascular Medicine and is now a board-certified cardiovascular nurse practitioner, CVNP-BC, in addition to being a certified hypertension clinician (CHC). The CVNP-BC training was “more acutely focused on cardiovascular health than my previous APRN training, including “more in-depth interpretations of electrocardiograms,” she says.

Salley was the first nurse practitioner in Kentucky to achieve the certification in hypertension from the American Hypertension Specialist Certification Program. She continues to be the only nurse practitioner in Kentucky to hold this achievement. She has been a cardiology nurse practitioner for eight years, having received her nursing degree and APRN certification at Eastern Kentucky University. On her own initiative, she researched the steps necessary to pass the certification test.

Baptist Health Medical Group Cardiology and Salley began the specialized in-office hypertension program in May 2021. Obstacles with COVID-19 restrictions initially affected patient flow. Salley says the practice used telehealth visits effectively and has seen a full return.

“My goal and personal philosophy are to provide safe, holistic, patientcentered care to the best of my abilities and to treat each patient with respect, dignity, and empathy.” — Kristy Salley, APRN, CVNP-BC, CHC

of in-office visits as COVID-19 infection rates have declined.

Individualized Patient Care

The patient population that Salley believes can most benefit from her care are patients with refractory hypertension who are on multiple anti-hypertensive medications with comorbidities such as coronary artery disease, diabetes mellitus, chronic kidney disease, obesity, and peripheral vascular disease. She says she often rules out patients for secondary causes of hypertension such as renal artery stenosis, hyperaldosteronism, or pheochromocytoma.

“With my certification, I provide expertise in the management of refractory hypertension with consideration of concomitant medical conditions. I follow and work closely with my patients to improve their blood pressure and overall health outcomes. I obtained my certification in hypertension so I could better serve our population of patients in Kentucky,” says Salley.

Hypertension is known as “the silent killer” because it is frequently undetected until a cardiac event. Refractory hypertension is the most challenging. Uncontrolled hypertension can lead to serious complications such as heart attacks, strokes, and organ damage. Salley states that she saw the need for Kentuckians to have a skilled health care provider with additional training specific in hypertension. For this reason, she chose to pursue this avenue to help the community.

“My goal and personal philosophy are to provide safe, holistic, patient-centered care to the best of my abilities and to treat each patient with respect, dignity, and empathy,” says Salley.

There’s a Mobile App for That

Since 2021, the hypertension program with Baptist Health Medical Group Cardiology has seen consistent growth. With an increase in patient volume, more clinic days have been added to accommodate patients struggling with resistant hypertension. “Hypertension is a major cardiovascular risk factor and is especially prevalent in Kentucky,” says Salley. The clinic has enabled her to help many patients obtain normalized blood pressure readings, even for those with resistant hypertension on multiple anti-hypertensive medications with other comorbidities.

A grant funded by the American Heart Association for hypertension was awarded to Baptist Health Paducah in late 2023, aimed at improving hypertension monitoring and management. The grant has enabled the implementation of a comprehensive program that includes staff training, the provision of blood pressure devices, and the introduction of the MyChart Care Companion app. Baptist Health Medical Group Cardiology is the first cardiology practice to benefit from the grant by utilizing the new app. The app connects to the patient’s MyChart account and provides several features, including tracking blood pressure more effectively and providing guidance on a healthy diet, weight loss, and stress management. This functionality is designed to target adults age 18+ with hypertension, hypertensive cardiovascular disease without heart failure, chronic kidney disease, secondary hypertension, and abnormal blood pressure readings without diagnosis, allowing the patient to participate more actively in their care and to communicate more with their provider to improve cardiovascular health.

“Each reading from the app is patient specific in real time. For those patients who are less tech-savvy, there’s a telephone helpline to walk patients through the process,” says Salley.