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Invited Commentary
December 8, 2021

Treatment Intensification and Missed Visits as Important Targets for Reducing Racial and Ethnic Disparities in Hypertension Control

Author Affiliations
  • 1Johns Hopkins School of Nursing, Baltimore, Maryland
  • 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 3Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 4Division of Health Sciences Informatics, Johns Hopkins School of Medicine, Baltimore, Maryland
JAMA Cardiol. 2022;7(2):213-214. doi:10.1001/jamacardio.2021.5003

Uncontrolled hypertension is a public health priority, with only 1 in 5 US adults with hypertension achieving blood pressure (BP) control.1 Furthermore, persistent racial and ethnic disparities in hypertension diagnosis and control are well documented. Compared with other racial and ethnic groups, Black individuals are more likely to be diagnosed with hypertension at a younger age, have inadequately controlled hypertension, and experience target organ damage.2 The reasons for these disparities are complex and include patient-, clinician-, system-, and society-level factors. Patient-level factors, including adherence to therapeutic lifestyle changes such as physical activity, heart-healthy diets, and prescribed antihypertension medications, are associated with racial and ethnic differences in hypertension control. However, there is increasing recognition that patient-level factors are mainly created by social factors associated with health and structural inequities that hamper control of BP.

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