Despite experiencing an increased risk for hypertension, Black patients often constitute a small proportion of clinical trial participants leading to a lack of data supporting evidence-based treatment decisions in this demographic. Until the Antihypertensive and Lipid-lowering Treatment to Prevent Heart Attack Trial, in which more than a third of participants were black, there was limited scientific evidence to inform treatment approaches. As a result of this trial, specific hypertension care recommendations were developed for Black patients. Nonetheless, racial inequities in hypertension treatment approaches persist and are particularly evident in therapeutic intensification practices.
Treatment intensification – including prescribing new medications of different classes or increasing doses of existing medications – is often critical for obtaining optimal blood pressure (BP) control in certain patients. However, recent data reports that Black patients are less likely to experience modifications in their treatment plans. As a result, racial inequities in treatment intensification could be responsible for up to over 20% of racial disparities in hypertension control, according to recent research presented at the American Heart Association (AHA) Scientific Sessions.