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Closing the Gap? Recent Trends in Racial Differences in Blood Pressure Control in the United States

Shakia T Hardy1, Byron C Jaeger2, Paul Muntner2

  • 1Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|May 22, 2026
PubMed

Insights

Most US adults have uncontrolled hypertension despite available treatments. This review examines the prevalence of uncontrolled blood pressure (BP) across racial and ethnic groups and discusses strategies for achieving BP equity.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Health Disparities

Background:

  • Most US adults have uncontrolled hypertension, failing to meet the 2025 American Heart Association/American College of Cardiology guideline targets (systolic BP ≥ 130 mmHg or diastolic BP ≥ 80 mmHg).
  • Significant racial and ethnic disparities in uncontrolled blood pressure (BP) have persisted for decades in the United States.
  • Black adults in the US exhibit a higher prevalence of uncontrolled BP compared to White adults.

Purpose of the Study:

  • To review current data on the prevalence of uncontrolled blood pressure (BP) across diverse racial and ethnic populations in the US.
  • To explore and discuss evidence-based approaches for addressing and reducing BP disparities.
  • To highlight strategies aimed at achieving blood pressure (BP) equity in hypertension management.

Main Methods:

  • Literature review of epidemiological studies and clinical data.
  • Analysis of national health surveys and cohort studies.
  • Synthesis of research on interventions targeting hypertension control and health equity.

Main Results:

  • Data consistently show a higher percentage of US Black adults experiencing uncontrolled hypertension compared to US White adults.
  • Prevalence rates of uncontrolled blood pressure (BP) vary significantly among different racial and ethnic groups.
  • Existing antihypertensive medications are effective, yet population-level control remains suboptimal, particularly in minority populations.

Conclusions:

  • Addressing the high prevalence of uncontrolled hypertension requires a focus on reducing racial and ethnic disparities.
  • Achieving blood pressure (BP) equity necessitates targeted strategies and interventions tailored to diverse populations.
  • Continued research and implementation of evidence-based approaches are crucial for improving hypertension control and health equity in the US.

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