Eliminating hypertension disparities in U.S. non-Hispanic black adults: current and emerging interventions

Abstract

Purpose of review: Hypertension in non-Hispanic black (NHB) adults in the United States has an earlier onset, higher prevalence, and increased severity compared with other racial/ethnic populations. Uncontrolled hypertension is responsible for the increased burden of cardiovascular disease (CVD) morbidity and mortality and decreased longevity in NHB adults. Unfortunately, eliminating the persistent hypertension-associated disparities and the white/black mortality gap, worsened by the COVID-19 pandemic, has been challenging. Overcoming the social determinants of health (SDOH), implementing therapeutic lifestyle changes (TLC), and using intensive guideline-directed medical therapy are required. Moreover, novel approaches, including community-based interventions and self-measured blood pressure (SMBP) monitoring, may mitigate U.S. disparities in hypertension.

Recent findings: In this review, we discuss recent data regarding the U.S. NHB adult disparate hypertension control and CVD morbidity and mortality. We note current approaches to address disparities, such as TLC, evidence-based pharmacotherapy, community-based interventions and SMBP. Finally, we explore future research and initiatives to seek hypertension-related health equity.

Summary: In the final analysis, longstanding, unacceptable hypertension and CVD morbidity and mortality in U.S. NHB adults must be addressed. Appropriate TLC and evidence-based pharmacotherapy benefit all populations, especially NHB adults. Ultimately, novel community-based interventions and SMBP may help overcome the SDOH that cause hypertension disparities.