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School of Public Health News May 23, 2024

""A recent study published in the Journal of the American Heart Association (JAHA), first-authored by Postdoctoral Fellow in the Department of Epidemiology Philip Akinyelure, M.D., shows that some of the higher apparent treatment-resistant hypertension risk among Black U.S. adults was mediated partly by adverse social determinants of health. The study, Social Determinants of Health and Incident Apparent Treatment‐Resistant Hypertension Among White and Black U.S. Adults: The REGARDS Study, observed that factors including low education, low income, lack of personal interaction with friends or family in the past month, lack of personal care if ill or disabled, lack of health insurance and living in a disadvantaged neighborhood or in states with poor health infrastructure all contributed to the risk in comparison to White U.S. adults.

This study is not the first led by Akinyelure using REGARDS data to observe the ways social determinants of health affect blood pressure. What is unique to this analysis is the association between social determinants of health and treatment-resistant hypertension, a worse form of uncontrolled blood pressure.

“Apparent treatment-resistant hypertension is defined as the need for four or more classes of antihypertensive medication to achieve controlled blood pressure,” said Akinyelure. “Individuals with apparent treatment-resistant hypertension have increased risk for adverse outcomes including stroke, coronary heart disease, heart failure, end-stage renal disease and all-cause mortality compared to those with hypertension without apparent treatment-resistant hypertension. To achieve health equity in terms of hypertension control, social determinants of health cannot be ignored.”  

Additional authors from the University of Alabama at Birmingham include Suzanne Oparil, M.D., Lonnie Hannon III, Ph.D., George Howard, DrPH and Shakia Hardy, Ph.D.

Read the full story from NIH

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