SOCIAL INEQUALITIES AND HYPERTENSION CONTROL IN PRIMARY HEALTH CARE: AN INTEGRATIVE REVIEW
DOI:
https://doi.org/10.63330/aurumpub.070-009Keywords:
Blood Pressure Control, Health Inequities, Hypertension, Primary Health Care, Social Determinants of HealthAbstract
Hypertension remains a major public health problem, and its control is influenced by both living conditions and the organization of health services. Objective: to analyze social inequalities related to the diagnosis, follow-up, and control of hypertension in the context of Primary Health Care. Method: an integrative literature review guided by the stages of question formulation, searching, selection, extraction, critical appraisal, and synthesis. The guiding question was: how do social determinants influence hypertension control among adults followed or reached by Primary Health Care? A preliminary search was conducted in PubMed/MEDLINE, covering publications from January 2020 to September 2026 in Portuguese, English, or Spanish. Original studies involving adults were considered if they analyzed blood pressure control or stages of the care continuum and at least one social, economic, racial or ethnic, territorial, or health care access marker. Eighteen studies were included in the preliminary synthesis. Results: lower income, unstable health care coverage, geographic barriers, residence in disadvantaged areas, racial and ethnic inequalities, low health literacy, and weak continuity of care were associated with poorer trajectories of diagnosis, adherence, and control. Treatment availability alone did not eliminate differences between social groups. Longitudinal relationships, regular access, person-centered organization, and place-based strategies showed potential to reduce these gaps. Conclusion: hypertension control does not depend solely on individual decisions or medication prescribing. It results from the interaction between living conditions and the ability of Primary Health Care to provide access, continuity, and care that is responsive to inequalities. Independent double-checking of study selection and data extraction must be completed before manuscript submission.
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