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Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
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Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
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Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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Hypertension II: Pathophysiology01:29

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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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Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis
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Utilizing a Health Equity Framework to Explore Patient-Level Factors Impacting Effective Hypertension Management

Justin Kramer1,2, David J Johnson1, Karen Wolf1

  • 1Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Medical Care Research and Review : MCRR
|December 1, 2025
PubMed
Summary

Social determinants of health impact hypertension management. Patient resources, health literacy, and mental health significantly influence outcomes, necessitating individualized, equity-informed care strategies.

Keywords:
SDOHblood pressure controlhealth equityhypertensionprimary care

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Area of Science:

  • Public Health
  • Health Equity
  • Cardiovascular Disease Research

Background:

  • Social determinants of health (SDOH) are key drivers of health disparities, particularly in cardiovascular outcomes like hypertension.
  • Understanding patient-level factors is crucial for effective hypertension management and reducing outcome disparities.

Purpose of the Study:

  • To assess patient-level factors influencing hypertension management using a health equity framework.
  • To explore differences in these factors across varying clinic performance levels and geographic settings.

Main Methods:

  • Qualitative study involving interviews with 29 healthcare providers and 25 patients with hypertension.
  • Utilized thematic analysis and open coding across 14 clinics (primary care and cardiology) in North Carolina and Kansas.
  • Included clinics categorized by performance: high, mid, and low-performing.

Main Results:

  • Five patient-level themes emerged: patient resources, health literacy, lifestyle, intentionality, and patient-centered care.
  • Health literacy was a critical barrier, with providers in low-performing clinics more frequently citing literacy challenges and linking rurality to decreased understanding.
  • Mental health (anxiety, depression) was identified as impacting hypertension management and treatment motivation.

Conclusions:

  • Individualized hypertension management strategies informed by health equity principles are essential.
  • Addressing patient resources, health literacy, and mental health is critical for improving hypertension outcomes.
  • Healthcare systems must recognize and mitigate the impact of SDOH on hypertension care.