Are Black Women Given Less Access to Blood Pressure Medication?

High blood pressure, also known as hypertension, is a common yet serious health condition that disproportionately affects Black women. The consequences of poorly managed hypertension are dire, leading to increased risks of heart disease, stroke and kidney failure. Yet, despite the availability of numerous FDA-approved medications, Black women often only receive two types. In contrast, their white counterparts have access to a broader range of treatments. This disparity raises critical questions about the role of racial bias in healthcare.

A Protocol Rooted in Racial Bias

Dr. Bayo Curry-Winchell, a physician who has extensively explored this issue, has made it her mission to shed light on the protocols that guide the treatment of hypertension in Black women. According to Curry-Winchell, the standard medical guidelines take a different approach for treating high blood pressure in Black individuals compared to others.

“This means that if you’re identified as ‘Black,’ the treatment options your doctor might suggest could be more limited, often focusing on just two types of medications: thiazide diuretics or calcium channel blockers,” she said to 21Ninety.

This is in stark contrast to non-Black patients, who might have access to a broader range of medications. This includes ACE inhibitors and ARBs, along with the diuretics and calcium channel blockers.

The Dangerous Consequences of Limited Blood Pressure Medication Options

The reasoning behind this protocol comes from historical data from clinical trials involving Black patients. However, Curry-Winchell highlights a significant flaw in this approach.

“These trials often overlook the vast genetic diversity within what we broadly categorize as ‘race,'” she explained.

She pointed out that race is a social construct. It is distinct from ethnicity and shouldn’t be the basis for determining medical treatment.

“For example, I’m a Black woman, but that doesn’t necessarily mean I’m African,” she said.,

There is a great danger in relying on race-based guidelines that do not account for individual patient needs.

The limitations imposed by these guidelines have real-world consequences. Curry-Winchell is very clear about the potential dangers.

“By restricting access to the full range of FDA-approved medications, this approach may prevent Black patients, especially women, from getting the treatments that could lead to better overall health outcomes,” Curry-Winchell shared.

The implications are severe, as inadequate blood pressure control can lead to complications, like kidney disease and cardiovascular issues. The focus on race rather than individual patient characteristics means that many Black women are missing out on the most effective, personalized treatments available.

Advocating for Change and Personalized Care

This issue is not just a matter of clinical guidelines. It reflects broader systemic problems in the healthcare system concerning racial disparities.

“When treatment decisions are based on race—a social construct—the healthcare system fails to deliver truly personalized, effective care to all patients,” Curry-Winchell said.

She points to the broader inequities in healthcare, such as the high rates of maternal mortality among Black women in the United States, as evidence of the need for a more nuanced and equitable approach to medical care.

Despite the clear need for change, Curry-Winchell has encountered resistance from other healthcare providers.

“Some clinicians are hesitant to change their approach, insisting that the current protocol isn’t harmful and continuing to practice race-based prescribing,” she said.

This resistance is rooted in ingrained habits and a lack of awareness about the evolving understanding of race in medicine. Because of this, it showcases the challenges faced by those advocating for a shift away from race-based treatment guidelines. For Black women navigating these systemic barriers, self-advocacy is crucial. Curry-Winchell advised that women educate themselves about all available treatment options and engage in open discussions with their healthcare providers.

“Ask about the full range of FDA-approved medications and request clear explanations for why certain medications are prescribed or withheld,” she said.

Seeking a second opinion and advocating for more diverse clinical trials can help ensure that treatment guidelines are more inclusive.

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