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Racial and Ethnic Differences in Shared Decision Making Among Patients With Hypertension: Results From the RICH

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Higher shared decision making (SDM) scores correlated with greater blood pressure reduction in hypertension patients. SDM also showed associations with race, ethnicity, and patient activation, highlighting its importance in diverse hypertension care.

Keywords:
clinical outcomeshealth equityhypertensionracial and ethnic disparitiesshared decision‐making

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Area of Science:

  • Public Health
  • Clinical Medicine
  • Health Disparities Research

Background:

  • Persistent racial and ethnic disparities exist in hypertension care.
  • Shared decision making (SDM) is recommended in hypertension guidelines.
  • Limited evidence explores the interplay of race, ethnicity, and SDM in hypertension management.

Purpose of the Study:

  • To investigate the relationships among SDM, blood pressure (BP) control, race, ethnicity, and other decision-making factors in hypertensive patients.
  • To understand how SDM influences hypertension outcomes in diverse populations.

Main Methods:

  • Longitudinal analysis of 1426 participants with uncontrolled hypertension from the RICH LIFE project.
  • Descriptive statistics, linear regression, and generalized estimating equations were employed.
  • Data included baseline characteristics, SDM scores, and BP measurements over 12 months.

Main Results:

  • Non-Latino Black individuals exhibited higher mean SDM scores compared to non-Latino White individuals (P<0.001).
  • A higher mean SDM score was associated with greater systolic blood pressure reduction over 12 months (β=-0.42, P=0.035).
  • SDM was linked to higher education, greater hypertension knowledge, perceived importance of BP medication, and patient activation.

Conclusions:

  • Increased SDM scores correlate with improved blood pressure control in hypertensive patients.
  • SDM is associated with racial/ethnic background, education, hypertension knowledge, and patient activation.
  • Further research is needed to explore SDM variations across racial and ethnic groups to optimize hypertension care.