{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:35:01Z","timestamp":1788050101742,"version":"build-2784847793"},"reference-count":60,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,5,21]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">We examined the association of multilevel social determinants of health with incident apparent treatment\u2010resistant hypertension (aTRH).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We analyzed data from 2774 White and 2257 Black US adults from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study taking antihypertensive medication without aTRH at baseline to estimate the association of social determinants of health with incident aTRH. Selection of social determinants of health was guided by the Healthy People 2030 domains of education, economic stability, social context, neighborhood environment, and health care access. Blood pressure (BP) was measured during study visits, and antihypertensive medication classes were identified through a pill bottle review. Incident aTRH was defined as (1) systolic BP \u2265140\u2009mm\u2009Hg or diastolic BP \u226590\u2009mm\u2009Hg, or systolic BP \u2265130\u2009mm\u2009Hg or diastolic BP \u226580\u2009mm\u2009Hg for those with diabetes or chronic kidney disease while taking \u22653 classes of antihypertensive medication or (2) taking \u22654 classes of antihypertensive medication regardless of BP level, at the follow\u2010up visit. Over a median 9.5\u2009years of follow\u2010up, 15.9% of White and 24.0% of Black adults developed aTRH. A percent of the excess aTRH risk among Black versus White adults was mediated by low education (14.2%), low income (16.0%), not seeing a friend or relative in the past month (8.1%), not having someone to care for them if ill or disabled (7.6%), lack of health insurance (10.6%), living in a disadvantaged neighborhood (18.0%), and living in states with poor public health infrastructure (6.0%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Part of the association between race and incident aTRH risk was mediated by social determinants of health.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.031695","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T10:54:48Z","timestamp":1715856888000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Social Determinants of Health and Incident Apparent Treatment\u2010Resistant Hypertension Among White and Black US Adults: The REGARDS Study"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3066-3310","authenticated-orcid":false,"given":"Oluwasegun P.","family":"Akinyelure","sequence":"first","affiliation":[{"name":"Department of Epidemiology University of Alabama at Birmingham Birmingham AL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7399-2299","authenticated-orcid":false,"given":"Byron C.","family":"Jaeger","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science Wake Forest University School of Medicine Winston\u2010Salem NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3060-0563","authenticated-orcid":false,"given":"Monika M.","family":"Safford","sequence":"additional","affiliation":[{"name":"Department of Medicine Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7505-2599","authenticated-orcid":false,"given":"Suzanne","family":"Oparil","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Alabama at Birmingham Birmingham AL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7970-6756","authenticated-orcid":false,"given":"April P.","family":"Carson","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Population Health Science University of Mississippi Medical Center Jackson MS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8525-4381","authenticated-orcid":false,"given":"Andrew","family":"Sims","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama at Birmingham Birmingham AL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Lonnie","family":"Hannon","sequence":"additional","affiliation":[{"name":"Department of Health Behavior University of Alabama at Birmingham Birmingham AL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3068-5720","authenticated-orcid":false,"given":"George","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama at Birmingham Birmingham AL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4711-5492","authenticated-orcid":false,"given":"Paul","family":"Muntner","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Alabama at Birmingham Birmingham AL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9211-0474","authenticated-orcid":false,"given":"Shakia T.","family":"Hardy","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of North Carolina at Chapel Hill Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.189141"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000084"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2013.140"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jash.2014.03.003"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.114.03850"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.12191"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/jch.13550"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.13304"},{"key":"e_1_3_2_10_2","unstructured":"American Medical Association . 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