Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA; Grady Health System, Atlanta, Georgia, USA. Electronic address: https://twitter.com/modeldoc.
Johns Hopkins School of Nursing, Baltimore, Maryland, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Electronic address: https://twitter.com/ycommodore.
J Am Coll Cardiol. 2021 Dec 14;78(24):2460-2470. doi: 10.1016/j.jacc.2021.06.017.
Hypertension is the leading cause of cardiovascular morbidity and mortality globally. In the United States, the prevalence of hypertension (blood pressure ≥130/80 mm Hg) among adults is approximately 45%. Racial/ethnic disparities in hypertension prevalence are well documented, especially among Black adults who are disproportionately affected and have one of the highest rates of hypertension globally. Hypertension control remains a persistent public health crisis. Recently published data indicate suboptimal hypertension control rates, particularly for racial/ethnic minority groups in the United States. This requires urgent action because of the significant health care burden from cardiovascular- and stroke-related morbidity and mortality. This clinical review delineates racial/ethnic disparities in the epidemiology of hypertension, and the impact of social determinants of health on the quality of cardiovascular care and outcomes. Clinical practice guideline recommendations and various national programs targeted toward hypertension control and proposed solutions to eliminate these disparities are discussed.
高血压是全球导致心血管发病率和死亡率的主要原因。在美国,成年人高血压(血压≥130/80mmHg)的患病率约为 45%。高血压患病率的种族/民族差异有充分的记录,尤其是在黑人成年人中,他们受影响不成比例,高血压患病率在全球处于最高水平之一。高血压的控制仍然是一个持续存在的公共卫生危机。最近公布的数据表明,高血压的控制率不理想,尤其是在美国的少数族裔群体中。由于心血管疾病和中风相关发病率和死亡率给医疗保健带来了巨大负担,因此需要采取紧急行动。本临床综述阐述了高血压流行病学中的种族/民族差异,以及健康社会决定因素对心血管护理质量和结果的影响。讨论了临床实践指南建议和各种针对高血压控制的国家计划,以及消除这些差异的建议解决方案。