Purpose of Review <p>High blood pressure is a leading cause of cardiovascular disease (CVD) morbidity and mortality worldwide, disproportionately affecting racial/ethnic populations in the United States (US). This review summarizes racial/ethnic inequities in CVD risk, hypertension (HTN), and the social determinants or drivers of health (SDOH), highlighting the 2025 American Heart Association/American College of Cardiology (AHA/ACC) High Blood Pressure Guideline.</p> Recent Findings <p>Certain US racial/ethnic populations experience disproportionate HTN burden, with Black adults demonstrating higher rates of resistant, nocturnal and masked HTN, hypertensive disorders of pregnancy, and dementia and cognitive decline. The 2025 AHA/ACC High Blood Pressure Guideline emphasizes the use of a novel race-neutral CVD risk calculator to guide initiation of pharmacotherapy, utilizing patient counseling and shared decision-making, alongside team-based, community-engaged HTN management strategies.</p> Summary <p>The 2025 AHA/ACC High Blood Pressure Guideline advances health equity, integrating the SDOH into improved CVD risk assessment and management recommendations. Effective mitigation of disparities to improve blood pressure and CVD outcomes demands optimizing healthcare access, addressing systemic discrimination, incorporating social context into shared clinical-decision making, and deploying culturally-tailored, community-based interventions.</p>