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  • Author
    Sean Faulk
  • PI

    Dr. Arleen Brown

  • Co-Author

    Atkia Sadia, Dr. Li-Jung Liang

  • Title

    Multilevel Multi-ethnic Strategies to Improve Hypertension Control: a Systematic Review

  • Program

    CTSI TL1 Summer Program

  • Other Program (if not listed above)

  • Abstract

    Background: Hypertension is a leading cause of cardiovascular disease in the U.S. and has a disproportionate impact on racial/ethnic minorities. National disparities in hypertension are reflected in Los Angeles County, home to the second-largest municipal health system in the nation, which serves a diverse population of vulnerable patients through a network of over 70 primary care clinics. Disparities in cardiovascular health can be addressed by reducing inequities in hypertension treatment, such as targeted medication management interventions; however, few studies have analyzed the effectiveness of such interventions in racial/ethnic minority populations.

    Methods: In this study, we conducted a systematic review to evaluate the effectiveness of medication management interventions for patient populations of multiple ethnicities. Studies were eligible if they were clinical trials conducted in the U.S. between 2000-2021 and included systolic blood pressure change as a primary or secondary outcome.

    Results: We retrieved 195 studies through initial search involving keywords related to hypertension, racial/ethnic minorities, and medication management. We identified 12 studies describing medication management strategies aimed at racial/ethnic minorities to be included in our analysis. Improved BP control was seen in interventions incorporating home blood pressure monitoring and provider-administered care. Few studies explicitly described the impact of cultural tailoring on interventions in minority communities.

    Conclusion: This study sets the stage for future work to incorporate effective, patient-centered, and culturally sensitive multilevel (patient/caregiver, provider, health system, community, policy) strategies into hypertension interventions to improve blood pressure control and reduce cardiovascular disparities in the Los Angeles County Department of Health Services.

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