Georgetown University, MedStar Washington Hospital Center, Washington, DC (A.C.).
Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore (A.Z., T.H.J.).
Hypertension. 2024 Mar;81(3):387-399. doi: 10.1161/HYPERTENSIONAHA.123.21354. Epub 2023 Dec 28.
High blood pressure causes over 10 million preventable deaths annually globally. Populations in low- and middle-income countries suffer the most, experiencing increased uncontrolled blood pressure and cardiovascular disease (CVD) deaths. Despite improvements in high-income countries, disparities persist, notably in the United States, where Black individuals face up to 4× higher CVD mortality than White individuals. Social determinants of health encompass complex, multidimensional factors linked to an individual's birthplace, upbringing, activities, residence, workplaces, socioeconomic and environmental structures, and significantly affect health outcomes, including hypertension and CVD. This review explored how social determinants of health drive disparities in hypertension and related CVD morbidity from a socioecological and life course perspective. We present evidence-based strategies, emphasizing interventions tailored to specific community needs and cross-sector collaboration to address health inequalities rooted in social factors, which are key elements toward achieving the United Nations' Sustainable Development Goal 3.4 for reducing premature CVD mortality by 30% by 2030.
高血压每年在全球导致超过 1000 万人死亡,其中低收入和中等收入国家的人口受影响最大,这些国家的人群血压控制不良和心血管疾病(CVD)死亡率上升。尽管高收入国家有所改善,但差距仍然存在,特别是在美国,黑人的 CVD 死亡率比白人高 4 倍。健康的社会决定因素包含与个人出生地、成长环境、活动、居住地点、工作场所、社会经济和环境结构相关的复杂多维因素,这些因素显著影响健康结果,包括高血压和 CVD。本综述从社会生态学和生命历程的角度探讨了健康的社会决定因素如何导致高血压和相关 CVD 发病率的差异。我们提出了基于证据的策略,强调针对特定社区需求的干预措施和跨部门合作,以解决源于社会因素的健康不平等问题,这是实现联合国可持续发展目标 3.4 的关键要素,该目标旨在到 2030 年将过早的 CVD 死亡率降低 30%。
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