Assigment .Apa seven . All instructions attached.

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Health Problem Proposal: Hypertension and Health Disparities

Anisleidy Alvarez

Florida national University

Health Promotion & Role Development in Adv. Nursing Practice

Dr. Nora Hernandez-Pupo

November 8, 2025

2

Health Problem Proposal: Hypertension and Health Disparities

Hypertension is a widespread and extremely important public health problem given its

wide-ranging impact on cardiovascular morbidity and mortality. Hypertension can be

asymptomatic for many individuals, yet it plays a significant role in heart disease, stroke, kidney

failure, and other critical health conditions. Given its high prevalence and the fact that control is

still suboptimal, hypertension is a major burden to health systems and individual quality of life

(Goorani et al. 2024). Importantly, differences are present in the occurrence, recognition,

management, and regulation across racial/ethnic, socioeconomic, and geographic boundaries,

emphasizing the necessity for health promotion and prevention initiatives to address both clinical

health aspects and social determinants of health. The substantial health impact of hypertension

provides a rationale for the choice of this condition for implementation in a health promotion

program that addresses the issues of disparities at multiple levels.

Global Relevance

Globally, hypertension is becoming a major global burden of disease-causing millions of

deaths per year associated with cardiovascular disease. Although the occurrence of uncontrolled

BP differs globally and regionally, in low and middle-income countries, a growing burden of

uncontrolled BP is associated with low access to care and resources (Schutte et al., 2021).

Almost half of hypertensive adults worldwide are unaware of their condition, elevating their risk.

(CDC, 2025). This is a global issue, which contributes to the underdevelopment of multinational

and cross-culture strategies for blood pressure awareness and control. International screening,

education and standardized treatment protocols are important because hypertension is usually

"silent." The international nature of hypertension makes it clear that while the previous efforts to

3

address it through local interventions are very important, the international nature of the problem

requires coordination across health systems.

National Level

At the national level in the US, however, the prevalence of hypertension has remained

alarmingly high. According to data available for August 2021-August 2023, nearly 1 in 2 US

adults had hypertension (defined as >=130/80 mm Hg or on antihypertensive medication) at 47.7

percent (Fryar et al., 2024). The rates of awareness, treatment, and control remain below optimal

levels. For instance, only one-fifth of adults with hypertension achieved blood pressure control

below 130/80 mm Hg during the specified period. Racial and ethnic disparities persist: non-

Hispanic Black individuals experience higher rates of hypertension compared to non-Hispanic

White or Hispanic individuals (48.8 percent versus 37.6 percent and 27.9 percent, respectively)

and face challenges with controlling blood pressure (Sells et al., 2023). These disparities are

linked to socioeconomic status and educational accomplishment, and access to care. For

example, poverty and lower education are associated with cardiovascular disease, particularly in

Black and Hispanic adults. Given the prevalence, poor control, and inequities in control and

treatment, a national health promotion strategy targeting understanding, screening, access, and

control is clearly needed.

Local Level

At a more localized level, within the state of Florida, hypertension continues to pose a

significant concern with spatial and social segregation. A recent data set shows that 35.9 percent

of Florida adults reported having been told by a health professional that they had high BP.

(America’s Health Ranking, 2023). Among federally qualified health centers (FQHCs) in Florida

4

in 2017, the statewide average hypertension control rate was about 57 % with much lower

hypertension control rates (37.8 %-51.4 %) in the lowest tertile, occurring mostly in northern

Florida counties which also have higher rates of BP-related death (CDC, 2024). These data

characterize the communities of disparity within a single state: factors of geography,

socioeconomic, and access are at play in creating disparities. For a health-promotion endeavor in

Florida, targeting areas with low control rates as well as underserved populations and/or linkage

to primary care and community outreach would be directly relevant and warranted.

Conclusion

Given the widespread prevalence of hypertension around the world, as well as the high

prevalence of the condition in the United States as a whole, as well as the differences in

prevalence, control, and outcomes that are specific to the state of Florida, the argument in favor

of developing multilevel health promotion programs is persuasive. For programs to be

successful, they must be implemented on a global, national, and local scale. Several of the

promotion strategies have the potential to lessen the burden of hypertension and to reduce health

disparities. These strategies include addressing the social determinants of health, developing

greater access to screening and care, improving awareness and compliance, and tailoring the

intervention to the needs of populations that are underserved. Therefore, hypertension is a health

problem selection that is suitable for the construction of a health promotion program that will

span the global, national, and local levels, as well as the inequities that exist in the prevention

and control of the problem. Both of these levels will be addressed in the program.

5

References

America’s Health Ranking. (2023). Explore High Blood Pressure in Florida | AHR.

Americashealthrankings.org.

https://www.americashealthrankings.org/explore/measures/Hypertension/FL

CDC. (2024, August 28). Hypertension Control among Federally Qualified Health Centers

(FQHCs) and Hypertension Death Rates by County, Florida. Heart Disease and Stroke

Maps. https://www.cdc.gov/heart-disease-and-stroke-data/data-vis/fl-hypertension-

fqhc.html

CDC. (2025, January 28). High blood pressure facts. High Blood Pressure.

https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html

Fryar, C., Kit, B., Carroll, M., Afful, J., Warren, A., Zablotsky, B., Leadbetter, E., & Maitland,

A. (2024). Hypertension Prevalence, Awareness, Treatment, and Control among Adults

Ages 18 and Older:United States, August 2021—August 2023. NCHS Data Brief, 511.

https://doi.org/10.15620/cdc/164016

Goorani, S., Zangene, S., & Imig, J. D. (2024). Hypertension: A Continuing Public Healthcare

Issue. International Journal of Molecular Sciences, 26(1), 123–123.

https://doi.org/10.3390/ijms26010123

Schutte, A. E., Venkateshmurthy, N. S., Mohan, S., & Prabhakaran, D. (2021). Hypertension in

Low- and Middle-Income Countries. Circulation Research, 128(7), 808–826.

https://doi.org/10.1161/circresaha.120.318729

Sells, M., Blum, E., Perry, G. S., Eke, P. I., & Presley-Cantrell, L. (2023). Excess Burden of

Poverty and Hypertension, by Race and Ethnicity, on the Prevalence of Cardiovascular

Disease. Preventing Chronic Disease, 20(20). https://doi.org/10.5888/pcd20.230065

1

Health Problem Proposal: Hypertension and Health Disparities

Anisleidy Alvarez

Florida national University

Health Promotion & Role Development in Adv. Nursing Practice

Dr. Nora Hernandez-Pupo

November 8, 2025

2

Health Problem Proposal: Hypertension and Health Disparities

Hypertension is a widespread and extremely important public health problem given its

wide-ranging impact on cardiovascular morbidity and mortality. Hypertension can be

asymptomatic for many individuals, yet it plays a significant role in heart disease, stroke, kidney

failure, and other critical health conditions. Given its high prevalence and the fact that control is

still suboptimal, hypertension is a major burden to health systems and individual quality of life

(Goorani et al. 2024). Importantly, differences are present in the occurrence, recognition,

management, and regulation across racial/ethnic, socioeconomic, and geographic boundaries,

emphasizing the necessity for health promotion and prevention initiatives to address both clinical

health aspects and social determinants of health. The substantial health impact of hypertension

provides a rationale for the choice of this condition for implementation in a health promotion

program that addresses the issues of disparities at multiple levels.

Global Relevance

Globally, hypertension is becoming a major global burden of disease-causing millions of

deaths per year associated with cardiovascular disease. Although the occurrence of uncontrolled

BP differs globally and regionally, in low and middle-income countries, a growing burden of

uncontrolled BP is associated with low access to care and resources (Schutte et al., 2021).

Almost half of hypertensive adults worldwide are unaware of their condition, elevating their risk.

(CDC, 2025). This is a global issue, which contributes to the underdevelopment of multinational

and cross-culture strategies for blood pressure awareness and control. International screening,

education and standardized treatment protocols are important because hypertension is usually

"silent." The international nature of hypertension makes it clear that while the previous efforts to

3

address it through local interventions are very important, the international nature of the problem

requires coordination across health systems.

National Level

At the national level in the US, however, the prevalence of hypertension has remained

alarmingly high. According to data available for August 2021-August 2023, nearly 1 in 2 US

adults had hypertension (defined as >=130/80 mm Hg or on antihypertensive medication) at 47.7

percent (Fryar et al., 2024). The rates of awareness, treatment, and control remain below optimal

levels. For instance, only one-fifth of adults with hypertension achieved blood pressure control

below 130/80 mm Hg during the specified period. Racial and ethnic disparities persist: non-

Hispanic Black individuals experience higher rates of hypertension compared to non-Hispanic

White or Hispanic individuals (48.8 percent versus 37.6 percent and 27.9 percent, respectively)

and face challenges with controlling blood pressure (Sells et al., 2023). These disparities are

linked to socioeconomic status and educational accomplishment, and access to care. For

example, poverty and lower education are associated with cardiovascular disease, particularly in

Black and Hispanic adults. Given the prevalence, poor control, and inequities in control and

treatment, a national health promotion strategy targeting understanding, screening, access, and

control is clearly needed.

Local Level

At a more localized level, within the state of Florida, hypertension continues to pose a

significant concern with spatial and social segregation. A recent data set shows that 35.9 percent

of Florida adults reported having been told by a health professional that they had high BP.

(America’s Health Ranking, 2023). Among federally qualified health centers (FQHCs) in Florida

4

in 2017, the statewide average hypertension control rate was about 57 % with much lower

hypertension control rates (37.8 %-51.4 %) in the lowest tertile, occurring mostly in northern

Florida counties which also have higher rates of BP-related death (CDC, 2024). These data

characterize the communities of disparity within a single state: factors of geography,

socioeconomic, and access are at play in creating disparities. For a health-promotion endeavor in

Florida, targeting areas with low control rates as well as underserved populations and/or linkage

to primary care and community outreach would be directly relevant and warranted.

Conclusion

Given the widespread prevalence of hypertension around the world, as well as the high

prevalence of the condition in the United States as a whole, as well as the differences in

prevalence, control, and outcomes that are specific to the state of Florida, the argument in favor

of developing multilevel health promotion programs is persuasive. For programs to be

successful, they must be implemented on a global, national, and local scale. Several of the

promotion strategies have the potential to lessen the burden of hypertension and to reduce health

disparities. These strategies include addressing the social determinants of health, developing

greater access to screening and care, improving awareness and compliance, and tailoring the

intervention to the needs of populations that are underserved. Therefore, hypertension is a health

problem selection that is suitable for the construction of a health promotion program that will

span the global, national, and local levels, as well as the inequities that exist in the prevention

and control of the problem. Both of these levels will be addressed in the program.

5

References

America’s Health Ranking. (2023). Explore High Blood Pressure in Florida | AHR.

Americashealthrankings.org.

https://www.americashealthrankings.org/explore/measures/Hypertension/FL

CDC. (2024, August 28). Hypertension Control among Federally Qualified Health Centers

(FQHCs) and Hypertension Death Rates by County, Florida. Heart Disease and Stroke

Maps. https://www.cdc.gov/heart-disease-and-stroke-data/data-vis/fl-hypertension-

fqhc.html

CDC. (2025, January 28). High blood pressure facts. High Blood Pressure.

https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html

Fryar, C., Kit, B., Carroll, M., Afful, J., Warren, A., Zablotsky, B., Leadbetter, E., & Maitland,

A. (2024). Hypertension Prevalence, Awareness, Treatment, and Control among Adults

Ages 18 and Older:United States, August 2021—August 2023. NCHS Data Brief, 511.

https://doi.org/10.15620/cdc/164016

Goorani, S., Zangene, S., & Imig, J. D. (2024). Hypertension: A Continuing Public Healthcare

Issue. International Journal of Molecular Sciences, 26(1), 123–123.

https://doi.org/10.3390/ijms26010123

Schutte, A. E., Venkateshmurthy, N. S., Mohan, S., & Prabhakaran, D. (2021). Hypertension in

Low- and Middle-Income Countries. Circulation Research, 128(7), 808–826.

https://doi.org/10.1161/circresaha.120.318729

Sells, M., Blum, E., Perry, G. S., Eke, P. I., & Presley-Cantrell, L. (2023). Excess Burden of

Poverty and Hypertension, by Race and Ethnicity, on the Prevalence of Cardiovascular

Disease. Preventing Chronic Disease, 20(20). https://doi.org/10.5888/pcd20.230065