# Bridging the Gap in Racial/Ethnic Disparities: Perspectives from the 2025 American Heart Association/American College of Cardiology High Blood Pressure Guideline

## TL;DR

The 2025 AHA/ACC High Blood Pressure Guideline addresses racial/ethnic disparities in hypertension and CVD by integrating social determinants of health into risk assessment and treatment strategies.

## Contribution

The 2025 AHA/ACC High Blood Pressure Guideline introduces a race-neutral CVD risk calculator and emphasizes community-based strategies to reduce disparities.

## Key findings

- Black adults experience higher rates of resistant, nocturnal, and masked hypertension, as well as hypertensive disorders of pregnancy.
- The new guideline promotes shared decision-making and team-based care to address hypertension disparities.
- Incorporating social determinants of health is critical for improving cardiovascular outcomes in marginalized populations.

## Abstract

High blood pressure is a leading cause of cardiovascular disease (CVD) morbidity and mortality worldwide, disproportionately affecting racial/ethnic populations in the United States (US). This review summarizes racial/ethnic inequities in CVD risk, hypertension (HTN), and the social determinants or drivers of health (SDOH), highlighting the 2025 American Heart Association/American College of Cardiology (AHA/ACC) High Blood Pressure Guideline.

Certain US racial/ethnic populations experience disproportionate HTN burden, with Black adults demonstrating higher rates of resistant, nocturnal and masked HTN, hypertensive disorders of pregnancy, and dementia and cognitive decline. The 2025 AHA/ACC High Blood Pressure Guideline emphasizes the use of a novel race-neutral CVD risk calculator to guide initiation of pharmacotherapy, utilizing patient counseling and shared decision-making, alongside team-based, community-engaged HTN management strategies.

The 2025 AHA/ACC High Blood Pressure Guideline advances health equity, integrating the SDOH into improved CVD risk assessment and management recommendations. Effective mitigation of disparities to improve blood pressure and CVD outcomes demands optimizing healthcare access, addressing systemic discrimination, incorporating social context into shared clinical-decision making, and deploying culturally-tailored, community-based interventions.