# Understanding Racial/Ethnic Disparities in Clinician Concordance with Hypertension Treatment Guidelines and Blood Pressure Control

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2024 · $727,972

## Abstract

Project Summary/Abstract
Despite an equal hypertension treatment rate between Blacks and Whites (79.7% vs. 79.1%), racial/ethnic
disparities in blood pressure (BP) control persist with lower rates in Blacks (39.2%), Hispanics (40.0%), Asians
(37.8%), compared to Whites (49.1%). Blacks in the Southeastern US were 27% less likely to achieve BP
control while they were 69% more likely to receive treatment. Existing studies point towards individual risk
factors and lack of healthcare access and insurance as potential causes for these disparities; however, even
after accounting for these factors, racial disparities in BP control persist. The reasons for this inequality are yet
to be fully understood. Additionally, BP control rates remain low (44%–57%) among treated hypertensives
while clinical trials have demonstrated that a high rate of BP control (ranging from 80-90%) can be achieved
with currently available therapies by strictly following recommended treatment protocols. This suggests that a
higher proportion of uncontrolled BP could be explained by less aggressive treatment, poorer follow-up, and
use of fewer or less effective drugs. Despite this, in a national survey, antihypertensive therapy was intensified
in only 22-40% of patients with uncontrolled hypertension, and 43% of physicians did not initiate drug therapy
unless systolic BP reached ≥160 mmHg. The 2017 Hypertension Treatment Guidelines advocate evidence-
based medication selection and titration, however, the role of provider concordance to these guidelines and its
impact on racial/ethnic disparity in BP control remains unexplored. Furthermore, conclusions from studies
regarding compliance with older hypertension treatment guidelines were compromised due to failure to
evaluate multiple aspects of hypertension care, such as comorbidities, follow-up, laboratory assessments, drug
side effects, and contraindications. We propose to address these limitations and use an objective and validated
measurement of concordance to treatment guidelines. We will utilize data from the Stakeholders, Technology,
and Research Clinical Research Network (STAR CRN) – a database of ~14 million racially diverse patients
from the Southeastern US, to evaluate: 1) the extent of racial disparity in hypertension treatment based on the
AHA/ACC 2017 guidelines in the southeastern US; 2) investigate the patient, physician, clinic, and geo-social
factors that predict racial/ethnic disparity in the treatment of hypertension according to recommended
guidelines; and 3) ascertain if racial disparity in BP control can be attributed to providers' lack of adherence to
treatment guidelines. Moreover, we aim to conduct qualitative interviews with clinicians and patients to gather
information on the reasons for providers' deviation from the guidelines and recommendations on improving
compliance with the guidelines. Our findings will offer valuable insights into the factors contributing to racial
disparities in the treatment of hype...

## Key facts

- **NIH application ID:** 10860639
- **Project number:** 1R01HL173523-01
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** YACOB G TEDLA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $727,972
- **Award type:** 1
- **Project period:** 2024-09-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10860639

## Citation

> US National Institutes of Health, RePORTER application 10860639, Understanding Racial/Ethnic Disparities in Clinician Concordance with Hypertension Treatment Guidelines and Blood Pressure Control (1R01HL173523-01). Retrieved via AI Analytics 2026-08-01 from https://api.ai-analytics.org/grant/nih/10860639. Licensed CC0.

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