HYPERTENSION LITERATURE REVIEW 2

Hypertension Literature Review

Hypertension is a condition that occurs when blood is pumped through the arteries with
abnormally high pressure (George & MacDonald, 2015). Causes of the condition include
environmental factors such as lifestyles that are unhealthy, genetic factors, obesity, blood vessel
structure, and kidney fluid-salt balances (George & MacDonald, 2015). The condition is a
leading cause of deaths not just in developing countries where prevalence remains high but also
in the United States. These deaths are mainly due to its effects on cardiovascular, central
nervous, and renal systems (George & MacDonald, 2015). It is estimated that 25% of all adult
Americans suffer from the condition (George & MacDonald, 2015). The prevalence among
African Americans is higher than that of any other race. Even though African Americans
constitute only 13% of the American population, the constitute a third of all Americans suffering
from hypertension (George & MacDonald, 2015). In addition to being more likely to develop
hypertension, African Americans are also more likely to develop some of the worst
complications of the condition. For instance, compared to whites, they are 1.5 times more likely
to suffer from heart disease, 1.8 times more likely to suffer from fatal stroke, and 4.2 times more
likely to suffer from end-stage renal disease (Nwabuo et al., 2014). Hypertension is, therefore, a
major health challenge. It is also a major cause of death in this population subgroup with 20% of
African American adult females and 30% of adult African American males succumbing to the
disease each year (Nwabuo et al., 2014).
Part of the reason why there is high mortality rate among African Americans with
hypertension is low level of awareness and control of the condition. The condition can be made
less lethal through effective management and care. Among African Americans, only three

HYPERTENSION LITERATURE REVIEW 3
quarters are aware that they have the condition (Nwabuo et al., 2014). Just 57% manage to
receive treatment for the condition (Nwabuo et al., 2015). The result has been low level of
control of the condition among African Americans. Nationwide, half of people suffering from
hypertension have managed to put it under control thus significantly reducing any possibility of
dying from the disease. However, among African Americans, just 25% have managed to put the
condition under control (Nwabuo et al., 2014). Various studies have attributed this low control
level of hypertension to a number of factors. These include African Americans being less likely
to have health insurance, less likely to adhere to medical treatment that they have been
prescribed, less likely to receive timely diagnosis, and less likely to access healthcare (Nwabuo
et al., 2014).
Given these factors, various studies have explored the use of telehealth in increasing the
level of hypertension control among African Americans. Telehealth is a broad term that includes
mobile health and telemedicine. It is applied in physician-patient interactions, education, care
delivery, reminders, monitoring, information sharing and diagnostics (O’Connor et al., 2014).
Telehealth has been found to be effective in helping to foster skills and knowledge that persons
suffering from hypertension need to engage in self-management of the condition in a successful
manner (Ephraim et al., 2015). Since persons suffering from hypertension require easy access to
care and continuous support, telehealth has the potential of significantly improving control of the
condition particularly among African Americans. This is because this population subgroup has
relatively poor access to healthcare services due to various barriers such as low socio-economic
status.

HYPERTENSION LITERATURE REVIEW 4

References

Ephraim, P., Briggs, F., Roter, D., Bone, L., Wolf, J., Boyer, L., … Cooper, L. (2015, July 1).
Improving Urban African Americans’ Blood Pressure Control through multi-level
Interventions in the achieving blood pressure control together (ACT) Study a randomized
clinical trial. National Institute of Health, 38(2), 370-382.
https://doi.org/10.1016/j.cct.2014.06.009
George, J., & MacDonald, T. (2015, December). Home blood pressure monitoring. European
Cardiology Review, 10(2), 95-101. https://doi.org/10.15420/ecr.2015.10.2.95
Nwabuo, C., Dy, S., Weeks, K., & Young, J. (2014, August 14). Factors associated with
appointment aon-adherence among African-Americans with severe, poorly controlled
hypertension. PLOS ONE. https://doi.org/10.1371/journal.pone.0103090
O’Connor, M., Asdornwised, U., Dempsey, M., Huffenberger, A., Jost, S., Flynn, D., & Norris,
A. (2016, April 20). Using telehealth to reduce all-cause30-day hospital
readmissionsamong heart failure patients receiving skilled home health services. Applied
Clinical Informatics, 7, 238-247. https://doi.org/10.4338/ACI-2015-11-SOA-0157