{"id":452486,"date":"2025-06-10T12:03:55","date_gmt":"2025-06-10T12:03:55","guid":{"rendered":"https:\/\/health.theemtspot.com\/?p=452486"},"modified":"2026-04-11T19:52:37","modified_gmt":"2026-04-11T19:52:37","slug":"race-impacts-shared-decision-making-and-blood-pressure-reduction-study-finds","status":"publish","type":"post","link":"https:\/\/www.theemtspot.com\/health\/race-impacts-shared-decision-making-and-blood-pressure-reduction-study-finds\/","title":{"rendered":"Race Impacts Shared Decision Making and Blood Pressure Reduction, Study Finds"},"content":{"rendered":"\n<p>A new clinical investigation published in the <em>Journal of the American Heart Association<\/em> confirms that <strong>race and ethnicity are significant determinants of engagement in shared decision making (SDM)<\/strong>, a communication model between patients and providers that is associated with greater blood pressure reductions.<\/p>\n\n\n\n<p>Data from a large U.S.-based randomized trial shows that <strong>higher SDM engagement improves treatment outcomes<\/strong> in individuals with uncontrolled hypertension and that <strong>racial disparities exist in SDM levels and corresponding BP control<\/strong>.<\/p>\n\n\n\n<p>The study draws attention to the structural role of education, knowledge, and race in shaping how patients participate in treatment decisions\u2014and the measurable cardiovascular outcomes that follow.<\/p>\n\n\n\n<p class=\"has-larger-font-size\">Key Study Highlights<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Black patients reported <strong>higher SDM scores than White patients<\/strong>, despite having higher baseline BP levels.<\/li>\n\n\n\n<li><strong>Greater SDM engagement was strongly associated with larger reductions in systolic BP<\/strong> at 12 months.<\/li>\n\n\n\n<li>Patients who believed medication was \u201cvery important\u201d showed greater SDM engagement.<\/li>\n\n\n\n<li>Surprisingly, <strong>having more than a high school education was linked with <em>lower<\/em> SDM scores<\/strong>.<\/li>\n\n\n\n<li>BP reductions were most pronounced in patients with <strong>higher SDM interaction over time<\/strong>.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"rtex-highlighter-1\">Background: Disparities in Hypertension Care and Medication Adherence<\/span><\/h2>\n\n\n\n<p>Hypertension prevalence is disproportionately high among <strong>Black and Latino patients<\/strong>, yet adherence to antihypertensive medications remains <strong>lower compared to White patients<\/strong>.<\/p>\n\n\n\n<p>These differences are often attributed to <strong>socioeconomic inequities and educational gaps<\/strong>, which may be mitigated through <strong>shared decision making strategies<\/strong>.<\/p>\n\n\n\n<p>SDM encourages patients to actively participate in choosing their treatment path, increasing adherence and satisfaction with care.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"rtex-highlighter-1\">Methodology: Assessing SDM and Blood Pressure Outcomes<\/span><\/h2>\n\n\n\n<p>The study analyzed 1,426 patients enrolled in the <em>Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone (RICH LIFE)<\/em> trial, which was conducted across 30 clinical sites in the United States.<\/p>\n\n\n\n<p>Participants had <strong>uncontrolled hypertension at baseline<\/strong>, with systolic BP readings averaging 149.9 mmHg in White patients, 151.8 mmHg in Latino patients, and 153.5 mmHg in Black patients.<\/p>\n\n\n\n<p>SDM engagement was measured using the <strong>CollaboRATE instrument<\/strong>, a validated patient-reported tool assessing clinician support in decision-making.<\/p>\n\n\n\n<p>Demographics were stratified by race: 59.2% Black, 32.2% White, and 8.6% Latino, with mean ages of 58, 65, and 57 years, respectively.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"rtex-highlighter-1\">Findings: Racial and Knowledge-Based Predictors of Engagement<\/span><\/h2>\n\n\n\n<p>At the 12-month follow-up, <strong>Black patients had significantly higher SDM scores than White patients<\/strong> (b = 0.14; P &lt; .001), even after adjusting for clinical variables.<\/p>\n\n\n\n<p><strong>Patient activation<\/strong>\u2014the extent to which individuals are engaged in their own health management\u2014was positively associated with SDM scores (b = 0.09; P = .001).<\/p>\n\n\n\n<p>Patients who believed that <strong>blood pressure medication was \u201cvery important\u201d<\/strong> had higher SDM scores (b = 0.06; P = .022).<\/p>\n\n\n\n<p>Paradoxically, individuals with <strong>education levels above high school<\/strong> reported <strong>lower SDM engagement<\/strong> (b = -0.08; P = .045), suggesting complexity in the way education interacts with care expectations.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"rtex-highlighter-1\">Blood Pressure Reduction: The Impact of Engagement<\/span><\/h2>\n\n\n\n<p>Patients who reported <strong>higher levels of SDM engagement had significantly greater reductions in systolic BP over time<\/strong>.<\/p>\n\n\n\n<p>At 12 months, greater SDM engagement was associated with a <strong>mean systolic BP reduction of 11.41 mmHg<\/strong> (P &lt; .001), with a further improvement linked to the time-by-SDM interaction (b = -0.42; P = .035).<\/p>\n\n\n\n<p>Other covariates influencing BP change included <strong>Black race vs. White (b = 3.14)<\/strong>, knowledge of what hypertension means (b = 1.71), <strong>comorbid diabetes (b = 1.60)<\/strong>, and <strong>age (b = 0.12)<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"rtex-highlighter-1\">Limitations and Call for Future Research<\/span><\/h2>\n\n\n\n<p>The study was limited by its <strong>underrepresentation of Latino patients<\/strong> and the <strong>absence of Asian, Native American, and multiracial groups<\/strong>, which restricts the generalizability of its findings.<\/p>\n\n\n\n<p>Authors noted that <strong>education, hypertension knowledge, patient activation, and cultural engagement<\/strong> may each uniquely affect SDM participation and BP outcomes.<\/p>\n\n\n\n<p>They recommend further research to better understand <strong>racial and ethnic SDM disparities<\/strong> in order to develop more responsive, equitable care models.<\/p>\n\n\n\n<p><\/p>\n\r\n\t\t\t<div id=\"daexthefu-container\"\r\n\t\t\t\tclass=\"daexthefu-container daexthefu-layout-side-by-side daexthefu-alignment-left\"\r\n\t\t\t\tdata-post-id=\"452486\">\r\n\r\n\t\t\t\t<div class=\"daexthefu-feedback\">\r\n\t\t\t\t\t<div class=\"daexthefu-text\">\r\n\t\t\t\t\t\t<h3 class=\"daexthefu-title\">Was this helpful?<\/h3>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<div class=\"daexthefu-buttons-container\">\r\n\t\t\t\t\t\t<div class=\"daexthefu-buttons\">\r\n\t\t\t\t\t\t\t\r\n\t\t\t<div class=\"daexthefu-yes daexthefu-button daexthefu-button-type-text\" data-value=\"1\">\r\n\t\t\t\t<div class=\"daexthefu-button-text\">Yes<\/div>\r\n\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t<div class=\"daexthefu-no daexthefu-button daexthefu-button-type-text\" data-value=\"0\">\r\n\t\t\t\t<div class=\"daexthefu-button-text\">No<\/div>\r\n\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\r\n\t\t\t\t<div class=\"daexthefu-comment\">\r\n\t\t\t\t\t<div class=\"daexthefu-comment-top-container\">\r\n\t\t\t\t\t\t<label id=\"daexthefu-comment-label\" class=\"daexthefu-comment-label\"><\/label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"daexthefu-comment-character-counter-container\">\r\n\t\t\t\t\t\t\t\t<div id=\"daexthefu-comment-character-counter-number\"\r\n\t\t\t\t\t\t\t\t\tclass=\"daexthefu-comment-character-counter-number\"><\/div>\r\n\t\t\t\t\t\t\t\t<div class=\"daexthefu-comment-character-counter-text\"><\/div>\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<textarea id=\"daexthefu-comment-textarea\" class=\"daexthefu-comment-textarea\"\r\n\t\t\t\t\t\t\t\tplaceholder=\"Type your message\"\r\n\t\t\t\t\t\t\t\tmaxlength=\"\r\n\t\t\t\t\t\t\t\t400\t\t\t\t\t\t\t\t\t\"><\/textarea>\r\n\t\t\t\t\t<div class=\"daexthefu-comment-buttons-container\">\r\n\t\t\t\t\t\t<button class=\"daexthefu-comment-submit daexthefu-button\">Submit<\/button>\r\n\t\t\t\t\t\t<button class=\"daexthefu-comment-cancel daexthefu-button\">Cancel<\/button>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\r\n\t\t\t\t<div class=\"daexthefu-successful-submission-text\">Thanks for your feedback!<\/div>\r\n\r\n\t\t\t<\/div>\r\n\r\n\t\t\t","protected":false},"excerpt":{"rendered":"<p>New data shows racial disparities in hypertension care engagement. Black patients had higher SDM scores and greater BP reduction over 12 months.<\/p>\n","protected":false},"author":2,"featured_media":452506,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_helpful_status":1,"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"_kad_post_classname":"","footnotes":""},"categories":[736,7],"tags":[],"class_list":["post-452486","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-blood-pressure"],"_links":{"self":[{"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/posts\/452486","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/comments?post=452486"}],"version-history":[{"count":1,"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/posts\/452486\/revisions"}],"predecessor-version":[{"id":538387,"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/posts\/452486\/revisions\/538387"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/media\/452506"}],"wp:attachment":[{"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/media?parent=452486"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/categories?post=452486"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.theemtspot.com\/health\/wp-json\/wp\/v2\/tags?post=452486"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}