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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

Insights

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.

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.
Abstract

Keywords:
African AmericanBlack Americanhealth equityhypertensionmulticomponent interventionprimary care

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