Beyond the Prescription Pad: Addressing Racial and Systemic Disparities in Hypertension Control
Adaku Onwuka MS1,2, Ravindrasingh Rajput1 MD, Amruta Rajput1 PhD, Shakira Rivera BA2, Alaa AE Ahmed MBBS2, Razan Ahmed MBBS2, Jannat Harris2 MS, Milan Kassahun BS2
1Department of Physiology, American University of Antigua college of Medicine, Jabberwock Road, Antigua and Barbuda
2The Next Generation John Foundation, 2796 Sudbury Trace Norcross Ga 30071
Abstract
Hypertension remains a leading risk factor for cardiovascular morbidity and mortality, disproportionately affecting marginalized populations in the United States. This narrative review explores the complex interplay of social determinants, healthcare access, structural racism, and cultural factors contributing to racial and ethnic disparities in hypertension prevalence, diagnosis, and control. African American and Hispanic populations continue to experience disproportionately higher rates of hypertension-related complications compared to their White counterparts, despite increased awareness and treatment efforts. The review highlights the multifactorial causes of these disparities, including implicit provider bias, differential prescribing patterns, limited access to quality healthcare, socioeconomic constraints, and underrepresentation in clinical trials. Additionally, community-level stressors such as food insecurity, neighborhood safety, and housing instability further exacerbate disease burden. Patient-provider communication gaps and cultural discordance also hinder effective management. The review evaluates various interventions, including community-based programs, culturally tailored education, and team-based care approaches, which have shown promise in improving outcomes. However, sustained progress requires systemic reforms that address upstream social determinants and integrate health equity into clinical practice and policy. Emphasizing the need for a multifaceted and interdisciplinary approach, the paper calls for greater investment in community engagement, workforce diversification, and equitable research funding. Addressing hypertension disparities is not only a medical imperative but also a social justice issue demanding coordinated action at institutional, community, and governmental levels. Through an equity-informed lens, this review offers insights for clinicians, policymakers, and educators striving to close the gap in hypertension outcomes across diverse populations.
Keywords- Hypertension Disparities, Social Determinants of Health, Structural Racism, Health Equity, Culturally Tailored Interventions, Policy Reform in Healthcare