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medRxiv PreprintsInternational7 October 2026

Hypertension disease natural history and healthcare utilization when treatment guidelines do not account for race

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Objective: To estimate the impact of removing race-adjusted antihypertensive treatment recommendations for Black adults on health outcomes, healthcare utilization, and racial/ethnic disparities. Materials and methods: A discrete-time state-transition microsimulation model of hypertension natural history and health system utilization was developed to simulate lifetime trajectories among 100,000 non-Hispanic Black and non-Hispanic white 40-year-old adults. We evaluated the effect of removing race-adjusted antihypertensive treatment recommendations under two scenarios: one assuming racial heterog
— medRxiv Preprints
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