Community-Based Social Support Programs for Older Adults with Hypertension: A Comprehensive Review of U.S. Models

Hypertension is a highly prevalent chronic condition affecting the majority of older Americans and driving cardiovascular morbidity and mortality. Community-based social support programs have emerged as complementary interventions to clinical care, aiming to improve blood pressure control, medication adherence, and psychosocial well-being among older adults. This review synthesizes current evidence on U.S. models of community support for hypertensive seniors. We describe the epidemiology of hypertension in older Americans, including recent prevalence and trends by age, sex, and race. We outline biological and social determinants of hypertension in later life and the theoretical role of social support in mitigating risk. Four types of interventions are reviewed: peer support groups, home-visit/community health worker programs, faith-based/senior center initiatives, and technology-assisted support. Illustrative case studies include New York City’s volunteer-led “Keep on Track” senior-center program, a faith-based hypertension control project in immigrant congregations, and a Los Angeles community health center implementing home blood-pressure monitoring. We summarize outcomes showing that these programs can modestly reduce systolic blood pressure and improve adherence and self-efficacy. Barriers include cultural/language gaps, funding constraints, workforce training, and regulatory limitations. We discuss policy implications and identify research gaps, emphasizing the need for larger trials and cost-effectiveness analysis. Our findings highlight that community-based social support is a promising strategy to augment hypertension care for older adults, addressing health disparities and promoting healthy aging.