COVID-19 Increases Health Inequities in Patients With Hypertension - The Cardiology Advisor

Among individuals with high blood pressure, COVID-19 has disproportionately affected underserved racial, ethnic, and socioeconomic groups, according to a report recently published in the Journal of the American Heart Association.

This report draws on the work of several sources, including a diverse group of experts that discussed this matter as well as rectification strategies at the recent Fourth Annual University of Utah Translational Hypertension Symposium.

The results of a nationwide blood pressure study of more than 50,000 adults show that a decrease in the numbers of people with healthy blood pressure levels is linked with inadequate health care and insurance. From 2017 to 2018, 40% to 46% of insured Americans had healthy blood pressure, compared with 22% of those who were uninsured. Compared with White adults, Black adults had a 12% lower likelihood for healthy blood pressure. The threshold for high blood pressure in this study was above 140/90 mmHg.

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An audit revealed that new health care visits to manage high blood pressure declined by 39% in the second quarter of 2020 compared with the same period in 2018 and 2019.

Lifestyle modifications, a lack of in-person visits, and poor medication adherence are challenges to healthy blood pressure. During the COVID-19 pandemic, hospitalizations for stroke, heart attack, and heart failure decreased, but out-of-hospital deaths increased by 20%.

Other researchers showed that bias among health care professionals resulted in differing care quality and clinical inertia, both of which affect blood pressure management. A concerning trend, according to investigators, is distrust of health care professionals by people of color. Trust can be improved through community intervention programs such as the successful BARBER trial in Los Angeles. A low percentage of health care researchers and medical school students are from under-resourced communities.

The study researchers concluded that "COVID-19 has disproportionately affected people from different racial and ethnic groups, those who are from under-resourced populations and communities that face historic or systemic disadvantages."

As noted by interviewee Adam Bress, PharmD, MS, "COVID-19 has also reminded us that when we design interventions, it is important to consider health equity from the beginning rather than as an afterthought."

Reference

COVID-19 pandemic magnified health inequities for people with high blood pressure. News release.Journal of the American Heart Association Report. May 19, 2021. Accessed May 25, 2021. https://www.eurekalert.org/pub_releases/2021-05/aha-cpm051721.php

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COVID19 Health Disparity Hypertension

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