Hypertension—A Social Disease in Need of Social Solutions

Hypertension is arguably a social disease, precipitated and exacerbated by the environments in which we live, work, play, and learn. 1 Akinyelure et al. 2 now remind us that the social exposures associated with hypertension are myriad, systemic, interrelated, insidious, and lifelong.Social determinants related to hypertension include the built environment, characterized by neighborhood greenspace and opportunity for physical activity, crowding, industry, and availability of healthy foods and pharmacies.3 Financial resources, associated with enhanced likelihood of behaviors may promote general and cardiovascular health, health literacy, and, importantly, health service access, accompanied by the opportunity to address hypertension.4 Data both decades-old and recent detail the contribution of educational attainment to hypertension, along with racial differences of the effect of education.5,6 Finally, social support, coming from the home, school, or neighborhood, may buffer stress and translate to increased successes with health-related behaviors and hypertension.7 In summary, hypertension is a social disease that is mediated by direct and indirect social determinants and factors.