Objective: To investigate whether specific social determinants of health could be a "health barrier " toward achieving blood pressure (BP) control and to further evaluate any differences between Black patients and White patients. Patients and Methods: We conducted a retrospective cohort study of 3305 patients with elevated BP who were enrolled in a hypertension digital medicine program for at least 60 days and followed up for up to 1 year. Patients were managed virtually by a dedicated hypertension team who provided guideline-based medication management and lifestyle support to achieve goal BP. Results: Compared with individuals without any health barriers, the addition of 1 barrier was asso-ciated with lower probability of control at 1 year from 0.73 to 0.60 and to 0.55 in those with 2 or more barriers. Health barriers were more prevalent in Black patients than in those who were White (44.6% [482 of 1081] vs 31.3% [674 of 2150]; P <.001). There was no difference at all in BP control between Black individuals and those who were White if 2 or more barriers were present. Conclusion: Patient-related health barriers are associated with BP control. Black patients with poorly controlled hypertension have a higher prevalence of health barriers than their White counterparts. When 2 or more health barriers were present, there was no differences in BP control between White and Black individuals.(c) 2022 Mayo Foundation for Medical Education and Research & BULL; Mayo Clin Proc. 2022;97(8):1462-1471
