# Tailoring a Telemedicine Hypertension Management Intervention for Black Patients

> **NIH NIH K23** · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2024 · $156,576

## Abstract

PROJECT SUMMARY/ABSTRACT
Clinic-based hypertension care falls short in achieving blood pressure control, particularly for Black patients
with hypertension. Sporadic clinic visits do not support adequate time to improve patients' skills in hypertension
self-care or provide reliable and adequate blood pressure values to clinicians to support therapeutic decisions.
Telemedicine management of hypertension (TM-HTN) is a team-based approach that overcomes many of the
challenges of clinic-based care by offering more time for self-management support and better diagnostic
accuracy by leveraging multiple home blood pressure values to support clinicians' confidence in titrating
medications. In a meta-analysis of US-based clinical trials, we found that TM-HTN improved blood pressure by
7.3/2.7 mmHg, compared with usual clinic-based care. However, the effect was significantly diminished in trials
that enrolled a sizeable portion (39-100%) of Black patients per trial (4.4/1.1 mmHg) compared to trials
enrolling majority White patients (9.3/4.0 mmHg, p<0.01), likely because TM-HTN is not tailored for socially
disadvantaged Black patients. Creating a contextually responsive TM-HTN intervention for socially
disadvantaged Black patients and the clinics they attend has the potential to control hypertension in this
population who suffer the highest burden and disparity in hypertension control. Our Specific Aims are to: 1)
Evaluate barriers and facilitators to TM-HTN use among socially disadvantaged Black patients, healthcare
providers, and health system leaders; 2) Refine TM-HTN intervention for socially disadvantaged Black patients
using a Human-Centered Design approach and identify suitable implementation strategies; and 3) Assess
feasibility of TM-HTN intervention in a pilot randomized controlled trial. Evaluating the feasibility of the
intervention that is responsive to the patient, provider, and system-level contextual factors has the promise to
improve blood pressure in socially disadvantaged Black patients and will help to launch the candidate's
independent patient-oriented research career to achieve his long-term goal of eliminating inequities in
cardiovascular disease prevention among vulnerable populations. The candidate has dedicated his
professional life to becoming a physician-scientist, studying cardiovascular prevention, epidemiology, and
outcomes research. He has accepted a faculty position at the Wake Forest University School of Medicine,
where a supportive research environment in the Department of Internal Medicine has made his career
advancement and approach to independence possible. To accomplish the goals of the proposed research, he
has assembled an experienced mentoring team with unique yet complementary expertise in qualitative and
mixed methods, implementation science, clinical trials, and health equity to guide his career development. The
candidate will undertake formal training in these areas to complement his prior medical, graduate, and
p...

## Key facts

- **NIH application ID:** 10984575
- **Project number:** 1K23HL171954-01A1
- **Recipient organization:** WAKE FOREST UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Yashashwi Pokharel
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $156,576
- **Award type:** 1
- **Project period:** 2024-09-01 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10984575

## Citation

> US National Institutes of Health, RePORTER application 10984575, Tailoring a Telemedicine Hypertension Management Intervention for Black Patients (1K23HL171954-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10984575. Licensed CC0.

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