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Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
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Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
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Reducing Racial Disparities in Hypertension Control Using a Multicomponent, Equity-Centered Approach.

Susan Mwikali Kioko1, Christina Council2, Cecilia Tomori3,4

  • 1Rockville Internal Medicine Group, Rockville, Maryland, USA.

Health Equity
|September 8, 2025
PubMed
Summary

A 12-week intervention significantly lowered blood pressure (BP) in Black Americans with uncontrolled hypertension. Culturally congruent care improved BP control, medication adherence, and hypertension knowledge.

Keywords:
African AmericanBlack Americanhealth equityhypertensionmulticomponent interventionprimary care

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Area of Science:

  • Public Health
  • Cardiovascular Health
  • Health Equity

Background:

  • Black Americans face the highest hypertension prevalence and mortality rates in the U.S.
  • Structural racism, discrimination, and inequities contribute to uncontrolled blood pressure (BP) in this population.
  • Evidence-based interventions show promise but are underimplemented in clinical settings.

Purpose of the Study:

  • To address the gap in clinical implementation of hypertension interventions for Black Americans.
  • To evaluate an integrated nursing/public health quality improvement study.
  • To assess the impact of a culturally congruent intervention on BP control.

Main Methods:

  • A 12-week, one-group pre/posttest design was used.
  • Participants (n=35) were Black Americans aged 18+ with uncontrolled hypertension in primary care.
  • Intervention included remote BP monitoring, weekly phone coaching, medication intensification, and a standardized hypertension protocol.

Main Results:

  • Significant reductions in both systolic (mean difference = 23) and diastolic BP (mean difference = 11) were observed.
  • 87% of participants achieved BP control at 12 weeks.
  • The intervention improved medication adherence and hypertension knowledge (p < 0.001).

Conclusions:

  • A multicomponent, culturally congruent quality improvement intervention effectively improved BP among Black Americans.
  • Scaled implementation of equity-centered, culturally congruent approaches is crucial.
  • Reducing racial disparities in hypertension control requires addressing systemic inequities.