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Review
. 2025 Jan 15;27(1):23.
doi: 10.1007/s11886-024-02171-x.

Closing the Gap: Digital Innovations to Address Hypertension Disparities

Bassel M Shanab  1 , Allison E Gaffey  2   3 , Lee Schwamm  4   5 , Matthew Zawalich  5 , Daniel F Sarpong  6 , Rafael Pérez-Escamilla  7 , Jocelyn Dorney  2 , Charlotte Cooperman  5 , Ryan Schafer  5 , Heather S Lipkind  8 , Yuan Lu  2   9   10   11 , Oyere K Onuma  1   12 , Erica S Spatz  13   14   15   16
Affiliations
Review

Closing the Gap: Digital Innovations to Address Hypertension Disparities

Bassel M Shanab et al. Curr Cardiol Rep. .

Abstract

Purpose of review: Significant inequities persist in hypertension detection and control, with minoritized populations disproportionately experiencing organ damage and premature death due to uncontrolled hypertension. Remote blood pressure monitoring combined with telehealth visits (RBPM) is proving to be an effective strategy for controlling hypertension. Yet there are challenges related to technology adoption, patient engagement and social determinants of health (SDoH), contributing to disparities in patient outcomes. This review summarizes the evidence to date for RBPM, focusing on the potential to advance health equity in blood pressure control and the existing levers for largescale implementation.

Recent findings: Several studies demonstrate the promise of RBPM programs to address health disparities through: (1) the use of cellular-enabled blood pressure machines that do not require internet access or smart devices to connect readings into the medical record; (2) emphasis on home blood pressure monitoring to illuminate the daily factors that influence blood pressure control, thereby increasing patient empowerment; (3) adoption of standardized algorithms for hypertension management; and (4) integration of services to address SDoH. Multidisciplinary, non-physician care teams that include nurses, pharmacists, and community health workers are integral to this model. However, most studies have not embraced all aspects of RBPM, and implementation is challenging as current payment models do not support the digital components of RBPM or a diverse workforce of hypertension providers.

Conclusion: To address hypertension disparities, RBPM programs need to integrate digital technology that is accessible to all users as well as multidisciplinary care teams that attend to the medical and social needs of populations experiencing health inequities.

Keywords: Digital health; Health inequities; Hypertension; MHealth; Prevention; Remote patient monitoring.

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Conflict of interest statement

Declarations. Competing Interests: The authors declare no competing interests. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors.

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