Top Things to Know: Rural Health and Health Disparities in Hypertension Management
Updated: June 25, 2026
Prepared by Maggie Eaton, PhD, APRN, FNP
- Hypertension prevalence is higher and blood pressure (BP) control is lower in rural populations compared with urban populations, contributing to excess cardiovascular morbidity and mortality.
- Structural barriers, including health care professional shortages, longer travel distances, transportation challenges, and hospital closures, limit access to timely diagnosis and management of hypertension in rural areas.
- Nonmedical drivers of health, including poverty, lower educational attainment, limited health literacy, and lack of access to health care services, contribute to disparities in hypertension awareness, treatment, and control in rural communities.
- Access to medications and pharmacies is a critical challenge in rural settings, where pharmacy deserts, higher out-of-pocket costs, and limited local resources may delay or prevent optimal treatment.
- Lifestyle and environmental factors, including limited access to healthy foods and food insecurity, contribute to poorer diet quality and higher hypertension risk in rural populations.
- Telehealth and remote blood pressure monitoring can improve access to care, but their impact may be limited by broadband availability, device access, and digital literacy barriers in rural populations.
- Self-measured blood pressure monitoring, particularly when combined with clinical support or team-based care, is associated with improved blood pressure control and is especially relevant for rural populations.
- Team-based care models that include nurses, pharmacists, community health workers, and other health professionals are associated with improved hypertension management and reduced therapeutic inertia.
- Culturally tailored and community-based interventions, including those involving community health workers and local organizations, are associated with improved engagement and hypertension outcomes in rural populations.
- Multilevel strategies, including policy initiatives, workforce expansion, telehealth infrastructure, and mobile health services, are needed to address persistent gaps in hypertension care and improve outcomes in rural populations.
Citation
Ford CD, Cameron NA, Clark D III, Derington CG, Hardy ST, Mattei J, Yarrington CD, Zoghby Z, Garovic VD; on behalf of the American Heart Association Council on Hypertension; Council on the Kidney in Cardiovascular Disease; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology. Hypertension. Published online June 25, 2026. doi: 10.1161/HYP.0000000000000263