Turkson-Ocran Ruth-Alma N, Ogungbe Oluwabunmi, Botchway Marian, Baptiste Diana Lyn, Owusu Brenda, Ajibewa Tiwaloluwa, Chen Yuling, Gbaba Serina, Kwapong Fredrick Larbi, Aidoo Emily L, Nmezi Nwakaego A, Cluett Jennifer L, Commodore-Mensah Yvonne, Juraschek Stephen P
Beth Israel Deaconess Medical Center; Boston, MA.
Harvard Medical School; Boston, MA.
Curr Cardiovasc Risk Rep. 2024 Dec;18(12):239-258. doi: 10.1007/s12170-024-00750-9. Epub 2024 Oct 25.
Hypertension remains a major public health concern globally and in the United States with significant racial/ethnic disparities in prevalence, treatment, and control. Despite effective treatments, undiagnosed or uncontrolled hypertension persists, leading to an increased risk of cardiovascular disease and substantial healthcare costs. Addressing hypertension disparities requires a comprehensive approach, integrating clinical interventions with community-based strategies. This review examines the current landscape of clinic-and community-based interventions designed to improve hypertension management and reduce disparities.
Clinic-based approaches highlighted include implementing evidence-based guidelines, using treatment algorithms, promoting self-management, integrating digital health technologies, and incorporating team-based care approaches. Community interventions discussed involve lifestyle modification programs, faith-based initiatives, trusted community spaces, culturally-tailored health education, engaging community health workers, and collaborative care models linking clinics and communities. This review stresses the importance of addressing SDoH, fostering community engagement, and delivering culturally competent care. Strengthening clinic-community linkages, evaluating long-term effectiveness and cost-effectiveness, leveraging technology and innovation, and addressing gaps in research for underrepresented groups are key priorities for advancing health equity in hypertension management.
To effectively close the widening gap in hypertension disparities, collaborative multi-level efforts integrating clinical excellence and community empowerment are essential to mitigate the disproportionate burden of hypertension among racial/ethnic minority populations.
高血压在全球和美国仍然是一个主要的公共卫生问题,在患病率、治疗和控制方面存在显著的种族/民族差异。尽管有有效的治疗方法,但未诊断或未控制的高血压仍然存在,导致心血管疾病风险增加和大量医疗费用。解决高血压差异需要一种综合方法,将临床干预与基于社区的策略相结合。本综述探讨了旨在改善高血压管理和减少差异的基于诊所和社区的干预措施的现状。
突出的基于诊所的方法包括实施循证指南、使用治疗算法、促进自我管理、整合数字健康技术以及采用基于团队的护理方法。讨论的社区干预措施包括生活方式改变计划、基于信仰的倡议、受信任的社区空间、文化定制的健康教育、吸引社区卫生工作者以及连接诊所和社区的协作护理模式。本综述强调了解决社会决定因素健康问题、促进社区参与以及提供具有文化能力的护理的重要性。加强诊所与社区的联系、评估长期有效性和成本效益、利用技术和创新以及解决代表性不足群体的研究差距是推进高血压管理健康公平的关键优先事项。
为了有效缩小高血压差异方面不断扩大的差距,整合临床卓越和社区赋权的多层次协作努力对于减轻种族/民族少数群体中高血压的不成比例负担至关重要。