Extension Rural Health & Nutrition

Hypertension in the Lens of a Healthcare Disparity

Posted on by altman5

Approximately 119.9 million Americans have been diagnosed with hypertension, making it one of the most common chronic diseases in the United States. In South Carolina, an estimated 1.5 million people have been medically diagnosed with this condition, which is often asymptomatic and is known as the “silent killer.” Hypertension affects nearly half of the adult population and is influenced by factors such as family history, geographic location, access to healthcare, age, and lifestyle. Understanding the risk factors, signs and symptoms, and available treatment options can help individuals manage hypertension, improve their quality of life, and reduce the risk of serious complications such as heart disease, stroke, and kidney disease.

What is hypertension?

Hypertension is elevated blood pressure in the arteries, both when the heart is pumping and at rest. Blood pressure is measured with a sphygmomanometer and reported in millimeters of mercury (mm Hg). A blood pressure reading is reported as two numbers: the systolic (top) and diastolic (bottom). The systolic reading is the amount of pressure in the arteries while the heart is contracting, and the diastolic reading is the amount of pressure in the arteries while the heart is at rest. Hypertension could affect systolic or diastolic blood pressure.

The Centers for Disease Control and Prevention (CDC) reports blood pressure readings as:

Figure 1: CDC Illustration of blood pressure categories. Image Credit: www.CDC.gov

Signs and Symptom

  • Chest pains
  • Shortness of breath
  • Back pain
  • Numbness /weakness
  • Blurred vision
  • Slurred speech
  • Please consider that some individuals do not experience any signs or symptoms

Complications

  • Decrease functioning of arterial walls: atherosclerosis
  • Increased risk of enlarged heart
  • Cognitive decline
  • Preeclampsia
  • Peripheral Arterial Disease
  • Increased risk of heart attack, stroke, and other cardiovascular issues such as heart failure

Do healthcare disparities impact the risks of individuals developing hypertension?

Healthcare disparity is a preventable difference in access to healthcare, quality of care, or health outcomes among different populations. Healthcare disparities can significantly increase the risk of developing hypertension, as well as the likelihood that hypertension will go undiagnosed, untreated, or poorly controlled. While disparities do not directly cause high blood pressure, they influence the social, economic, and environmental conditions that contribute to its development and management.

Figure 2: A sphygmomanometer, also known as a blood pressure cuff. Image Credit: Adobe Stock

Some of the primary ways healthcare disparities impact hypertension include:

  • Limited access to healthcare: Individuals without consistent access to primary care, health insurance, or affordable medications are less likely to receive routine blood pressure screenings, early diagnosis, and effective treatment. Find Clinics – SC Free Clinic Association
  • Socioeconomic factors: Lower income, unemployment, lower educational attainment, and food insecurity are associated with higher rates of hypertension. These factors can make it difficult to afford healthy foods, medications, or regular medical visits. DCI
  • Neighborhood and environmental conditions: Communities with limited access to grocery stores, safe places to exercise, and quality housing often experience higher rates of hypertension due to increased stress and fewer opportunities for healthy lifestyles.
  • Chronic stress: Financial strain, discrimination, job insecurity, and exposure to violence or unsafe living conditions can lead to prolonged stress, which contributes to elevated blood pressure over time. Stress and the Autonomic Nervous System – Extension Rural Health & Nutrition
  • Nutrition and food access: Living in areas with limited access to fresh fruits, vegetables, and other nutritious foods can increase reliance on processed foods that are high in sodium, a major risk factor for hypertension. The American Heart Association suggests no more than 1,500-2,300 mg of sodium per day. SC State Farmers Market | South Carolina Department of Agriculture
  • Health education: Individuals who have difficulty understanding health information or navigating the healthcare system may be less likely to recognize hypertension risk factors, follow treatment plans, or make recommended lifestyle changes. Hypertension Management Program (HMP) Toolkit | High Blood Pressure | CDC
  • Systemic inequities: Historical and ongoing inequities in healthcare delivery, quality of care, and social policies have contributed to disproportionately higher rates of hypertension and related complications in some populations.

Hypertension can be self-managed by reducing the risks of stressors through regular engagement in physical and social activities, mental stimulation, and effective resource navigation. Promoting equitable access to healthcare and community resources is essential, particularly for vulnerable populations, to support overall well-being and maintain cognitive health as individuals age.

The Clemson University Rural Health and Nutrition (RHN) Team provides support for individuals managing chronic health conditions such as diabetes and related illnesses. For more information or to learn about upcoming sessions, contact the RHN team at healthextension@clemson.edu

References:

Authors:

  • Jevencia Hill, Rural Health and Nutrition Agent, Richland, Lexington, and Kershaw Counties
  • Justin Foxworth, Rural Health and Nutrition Agent, Dillon and Marlboro Counties

Reviewed By:

  • Michelle Altman, Extension Associate, Rural Health and Nutrition

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