Send to

Choose Destination
J Clin Hypertens (Greenwich). 2017 Oct;19(10):1015-1024. doi: 10.1111/jch.13089. Epub 2017 Aug 30.

Disparities in hypertension and cardiovascular disease in blacks: The critical role of medication adherence.

Author information

Tulane Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA, USA.
Department of Clinical Research & Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
Cardiovascular and Endocrine Liaison Program, Office of the Commissioner/External Affairs/Health & Constituent Affairs, Food and Drug Administration, Silver Springs, MD, USA.
Lewin and Associates LLC, National Coalition on Health Care, Washington, DC, USA.
CryerHealth, Washington, DC, USA.
Center for Drug Evaluation Research, Food and Drug Administration, Silver Springs, MD, USA.


Blacks are two to three times as likely as whites to die of preventable heart disease and stroke. Declines in mortality from heart disease have not eliminated racial disparities. Control and effective treatment of hypertension, a leading cause of cardiovascular disease, among blacks is less than in whites and remains a challenge. One of the driving forces behind this racial/ethnic disparity is medication nonadherence whose cause is embedded in social determinants. Eight practical approaches to addressing medication adherence with the potential to attenuate disparities were identified and include: (1) patient engagement strategies, (2) consumer-directed health care, (3) patient portals, (4) smart apps and text messages, (5) digital pillboxes, (6) pharmacist-led engagement, (7) cardiac rehabilitation, and (8) cognitive-based behavior. However, while data suggest that these strategies may improve medication adherence, the effect on ameliorating racial/ethnic disparities is not certain. This review describes the relationship between disparities and medication adherence, which likely plays a role in persistent disparities in cardiovascular morbidity and mortality.


Adherence; Food and Drug Administration; blacks; cardiovascular disease; health disparities; hypertension; race/ethnicity

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center