Hypertension affects over 116 million adults in the United States, with direct costs projected to exceed $220 billion by 2035. Disparities are well-documented in hypertension treatment, control and outcomes. Prevalence among Black Americans is much higher than non-Hispanic whites, and deaths attributable to hypertension are twice as frequent.

In Durham County, the prevalence of hypertension is 42%, with a strong association with residential racial isolation, suggesting opportunities to intervene at a neighborhood level to reduce hypertension disparities and improve overall population health.

Building on the work of the previous team, this project team focused on the policy implications of a January 2022 ruling from the Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality that enables patient-reported self-monitored blood pressure (SMBP) readings to count as valid and reliable measures of the Healthy People 2030 blood pressure quality goals. 

Team members worked to:

1. Reduce barriers to effective care (SMBP and optimized treatment) in the Durham community through targeted opportunities to improve access to care regarding blood pressure monitoring, diet, exercise and medical management. 
2. Adapt proven strategies (patient-portal self-reported electronic health record communication strategies) for blood pressure measurement, monitoring and reporting, and improve delivery of evidence-based interventions to the Durham community, including the use of community-based resources, with guidance from and partnership with community members and stakeholders.
3. Design an implementation and evaluation plan tailored to Durham County with patient and community stakeholders, with a focus on using the patient portal for SMBP and continuous quality improvement, and monitoring county-wide blood pressure outcomes through feedback and data dashboards.
4. Develop a sustainability plan with community and external stakeholders using common practices that are generalizable to other communities and regions. 

Timing

Summer 2022 – Summer 2023

Team Outputs

Reducing Hypertension Disparities in Durham (2023 Fortin Foundation Bass Connections Virtual Showcase)

Closing the Gap on Health Disparity and Outcomes in Hypertension: Utilizing a Quality Improvement Method for Hypertension Management Among Black Patients (Poster by Jada Allen, Devan Desai, Megan Gaines, Rohan Gupta, Camryn Johnson, Chenxinan Ma, Jennifer Nguyen, Ashna Sai, Aemilia Sprouse, David Surzykiewicz, Anna Tharakan, Aiyana Villanueva, Vivien Wambugu, Velda Wang, Elliot Yoon, Holly Biola and Bradi Granger, presented at Fortin Foundation Bass Connections Showcase, April 19, 2023)

Closing the Gap on Health Disparity and Outcomes in Hypertension (Devan Desai and Anna Tharakan, lightning talk at Fortin Foundation Bass Connections Showcase, April 19, 2023)

Anna Tharakan, Devan P. Desai, Rohan Gupta, Vivien Wambugu, Holly R. Biola, Bradi B. Granger. Applying the RE-AIM Framework To Evaluate an Educational Model To “Close the Gap” and Improve Health Equity in Uncontrolled Hypertension. 2024. Patient Education and Counseling, vol. 119.

This Team in the News

Bass Connections Teams Share Research Highlights at 2023 Showcase

Senior Spotlight: Reflections from the Class of 2023

See related teams, Closing the Gap on Health Disparities and Outcomes in Hypertension (2023-2024) and Closing the Gap on Health Disparity and Treatment Outcomes in Hypertension (2020-2021).

Image: Health Problems Caused by Hypertension, from The Surgeon General’s Call to Action to Control Hypertension