Interventions with social determinants of health may help prevent uncontrolled blood pressure, while reducing cardiovascular disease deaths annually

Because hypertension and uncontrolled blood pressure are major risk factors for heart disease and stroke, achieving equity in heart and brain health in the United States cannot be reached without paying attention to social determinants of health, a study shows.
BP and Social Determinants Stream

About half of adults in the United States with uncontrolled hypertension have a blood pressure of 140/90 mmHg or higher, according to the Centers for Disease Control and Prevention.

Hypertension disproportionately affects men –– especially Black men as compared to their white counterparts. A new study published in Hypertension suggests that social determinants such as low education, low income, living in an area with a shortage of health professionals, disadvantaged neighborhood and high-poverty ZIP code contributes to the excess likelihood of uncontrolled BP among Black adults compared to white adults. 

“This is an important finding because determining the contribution of social determinants of health impacting Black adults with uncontrolled blood pressure can inform interventions to improve BP control and reduce cardiovascular disease,” said Philip Akinyelure, M.D., postdoctoral student at the University of Alabama at Birmingham School of Public Health’s Department of Epidemiology and the principal investigator of the study.

According to Akinyelure, these interventions will not just prevent uncontrolled BP among the Black population but also contain the estimated 8,000 excess cardiovascular disease deaths among Black adults annually as both diseases are closely linked.

“Policies that dismantle systemic racism and address social determinants of health at the federal, state and local levels are needed,” Akinyelure said. “Widespread implementation of social interventions that have shown promising results at improving controlled blood pressure among Black adults could decrease disparities. We would like to see improvement in the collection of data on social determinants of health in clinics and in population-based studies. Also, clinicians should do more diligence to collect and assess the social determinants of health of patients and link socially disadvantaged patients to available resources in the community.”

The study used data from REGARDS, an ongoing, national cohort study sponsored by the National Institutes of Health. The goal of the study is to answer why Southerners and Black Americans have higher rates of stroke and related diseases that affect brain health.