Racial Differences and Social Determinants of Health in Achieving Hypertension Control Article

Full Text via DOI: 10.1016/j.mayocp.2022.01.035 Web of Science: 000880108300009

Cited authors

  • Milani RV, Price-Haywood EG, Burton JH, Wilt J, Entwisle J, Lavie CJ


  • Objective: To investigate whether specific social determinants of health could be a "health barrier " toward achieving blood pressure (BP) control and to further evaluate any differences between Black patients and White patients. Patients and Methods: We conducted a retrospective cohort study of 3305 patients with elevated BP who were enrolled in a hypertension digital medicine program for at least 60 days and followed up for up to 1 year. Patients were managed virtually by a dedicated hypertension team who provided guideline-based medication management and lifestyle support to achieve goal BP. Results: Compared with individuals without any health barriers, the addition of 1 barrier was asso-ciated with lower probability of control at 1 year from 0.73 to 0.60 and to 0.55 in those with 2 or more barriers. Health barriers were more prevalent in Black patients than in those who were White (44.6% [482 of 1081] vs 31.3% [674 of 2150]; P <.001). There was no difference at all in BP control between Black individuals and those who were White if 2 or more barriers were present. Conclusion: Patient-related health barriers are associated with BP control. Black patients with poorly controlled hypertension have a higher prevalence of health barriers than their White counterparts. When 2 or more health barriers were present, there was no differences in BP control between White and Black individuals.(c) 2022 Mayo Foundation for Medical Education and Research & BULL; Mayo Clin Proc. 2022;97(8):1462-1471

Publication date

  • 2022

Published in

International Standard Serial Number (ISSN)

  • 0025-6196

Number of pages

  • 10

Start page

  • 1462

End page

  • 1471


  • 97


  • 8