Hypertension control remains a persistent clinical problem and public health challenge, especially among certain racial/ethnic minority groups and hypertension where the prevalence is high, according to a clinical review published in the Journal of the American College of Cardiology as part of a nine-part Focused Seminar series addressing racism and health equity in cardiovascular care. The authors, led by Keith C. Ferdinand MD, FACC, offer a closer look at several clinical approaches that could help reverse this trend.

The review provides an overview of racial/ethnic disparities in the epidemiology of hypertension and details the impact of social determinants of health, racism and bias on the quality of cardiovascular care and outcomes.

The authors note that "racial/ethnic disparities in hypertension prevalence are well documented, especially among Black adults who are disproportionately affected and have one of the highest rates of hypertension globally." They also highlight the higher burden of coronary artery disease, heart failure, stroke, peripheral arterial disease, chronic renal disease, dementia and other complications linked to hypertension faced by certain racial/ethnic minority groups. Stark disparities in maternal outcomes, particularly among Black women, as well as COVID-19 morbidity and mortality, are also called out in the review.

Ferdinand and colleagues stress the need for "urgent action" to improve existing suboptimal hypertension control rates, including the routine consideration of social determinants of health in clinical assessments. They also highlight the importance of team-based care, strengthening community-based interventions and outreach and utilizing self-measured BP and telemedicine. Incorporating racial/ethnic differences in clinical guideline recommendations and the development and support for national programs targeted towards hypertension control are other approaches that need to be considered.

"We must ensure the existing disparities in clinical care are not worsened and there are continued efforts to promote equitable health care access for all," they write.

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, COVID-19 Hub, Heart Failure and Cardiomyopathies, Noninvasive Imaging, Prevention, Valvular Heart Disease, Atherosclerotic Disease (CAD/PAD), Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Echocardiography/Ultrasound, Hypertension, Sleep Apnea

Keywords: Cardiology, Prejudice, Racism, Selection Bias, African Americans, Algorithms, Asian Americans, Atrial Fibrillation, Bariatric Surgery, Cardiomyopathy, Dilated, Benchmarking, Cardiomyopathy, Hypertrophic, Cardiopulmonary Resuscitation, Cardiovascular Diseases, Community Health Services, Coronary Artery Disease, COVID-19, Cultural Competency, Death, Sudden, Cardiac, Defibrillators, Implantable, Diabetes Mellitus, Type 2, Dementia, Echocardiography, Economic Status, Sexual and Gender Minorities, Ethnic Groups, Evidence-Based Medicine, Food Insecurity, Glycated Hemoglobin A, Health Care Costs, Health Equity, Health Personnel, Healthcare Disparities, Heart Disease Risk Factors, Heart Valve Diseases, Hospitals, Hispanic Americans, Heart Failure, Housing, Hypertension, Implementation Science, Insurance, Insurance Coverage, Minority Groups, Motivation, Morbidity, Obesity, Organizational Objectives, Outcome Assessment, Health Care, Out-of-Hospital Cardiac Arrest, Patient Discharge, Patient-Centered Care, Peripheral Arterial Disease, Prescriptions, Policy, Prevalence, Public Health, Quality Improvement, Reference Standards, Registries, Religion, Renal Insufficiency, Chronic, Reward, Risk Factors, Social Determinants of Health, Social Justice, Social Responsibility, Stroke, Survival Rate, Telemedicine, Telemedicine, Treatment Outcome, Trust, Violence, Violence, Workforce

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