Hypertension causes the heart to pump blood very forcefully, creating a blood pressure consistently higher than 130/80 millimeters of mercury (mm Hg)Trusted Source. If either number in the blood pressure reading is high, a person has hypertension.
Hypertension increases the risk of heart disease and some other health concerns. Black people, especially Black men, live shorter livesTrusted Source, on average, than people of most other racial groups — particularly white people.
At the same time, not all Black people are African American. Some research presents results that are difficult to interpret because it uses these terms interchangeably.
Numerous studies have documented high rates of hypertension in African American people compared with those in other racial groups.
One 2018 study in the Journal of the American Heart AssociationTrusted Source found that, of its participants, 75.5% of Black men and 75.7% of Black women developed hypertension by the age of 55 years. This compares with 54.5% of white men and 40% of white women.
It is important to note that the study sites were only located in Chicago, Birmingham, Oakland, and Minneapolis. For this reason, the results do not represent the entire African American population.
According to the Centers for Disease Control and Prevention (CDC)Trusted Source, the overall prevalence of high blood pressure is 54% among non-Hispanic Black adults, compared with 46% in non-Hispanic white adults, 39% in non-Hispanic Asian adults, and 36% in Hispanic adults.
According to one 2014 article in the American Journal of Medical ScienceTrusted Source, on average, a 45-year-old African American man who lives in the southeastern U.S. has the same risk of having a stroke as a 55-year-old white man living in the same region or a 65-year-old white man living in the Midwest.
Researchers have not identifiedTrusted Source a single cause of hypertension in any group, including African American people. Instead, they believe that several factors may work together to cause high blood pressure.
These factors include:
- Medical racism: Several studies have documented a pattern of racism against Black people seeking healthcare, showing that doctors may not listen to their concerns, may delay treatment, or may not recommend appropriate treatment. One 2019 studyTrusted Source detected rampant bias in a medical decision making software program.
- Racism: Chronic exposure to racism is associated with hypertension. A 2014 systematic reviewTrusted Source found that perceived exposure to racism correlated with an increase in the risk of developing high blood pressure.
- Lifestyle risk factors: A number of lifestyle factors — including eating a high salt, high fat diet, having a lack of access to quality food, and getting little exercise — can increase the riskTrusted Source of hypertension. Socioeconomic factors, such as housing disparities and other inequities based on systemic racism, may increase African American people’s exposure to these risk factors.
- Resistant hypertension: African American people are more likelyTrusted Source to have resistant hypertension, which occurs when blood pressure does not drop in response to medication. Researchers do not know why this is, so they need to do more research on this topic.
- Earlier hypertension: Black Americans develop high blood pressure earlier in life than people in other racial groups do. In fact, one 2019 studyTrusted Source found that 31% of Black adults aged 18–44 years had hypertension.
It is important to note that some studies specifically look at Black Americans, who are part of a racial group subjected to racism and similar socioeconomic factors. However, Black Americans are a diverse group of people from many different cultural and ethnic backgrounds.
Being Black is a risk factor for developing high blood pressure. Some other risk factors interact with being Black, such as chronic stress related to racism.
These other risk factors for hypertension include:
- having a family history of high blood pressure
- having diabetes
- having a high intake of alcohol
- eating a high salt or high fat diet
- having obesity
- being older
Having exposure to race-related stress, such as fearing or experiencing racist acts, may also elevate blood pressure.
High blood pressure means that the heart is pumping blood more forcefully than usual.
Hypertension may cause health issuesTrusted Source such as:
To diagnose high blood pressure, a doctor uses a blood pressure monitor. They consider a blood pressure reading to be high if it is 130/80 mm HgTrusted Source or above. Multiple high readings suggest that the person has hypertension.
Some people, such as those who get very anxious at doctor’s appointments, may have high blood pressure at their appointment and normal blood pressure at home. This is called white coat hypertension.
When this happens, a doctor may recommend that the person monitors their own blood pressure at home. The person can do this using a home blood pressure monitor.
Some pharmacies, malls, and other locations offer kiosks that a person can use to monitor their own blood pressure at no cost.
However, the Food and Drug Administration (FDA)Trusted Source say that these kiosks can only provide accurate readings if the cuff fits a person’s arm properly. Therefore, a person should be sure to choose a blood pressure monitor that fits their arm.
Treatment depends on how high a person’s blood pressure is. In most cases, a doctor may recommendTrusted Source making lifestyle changes, such as eating less salt, getting more exercise, or losing weight. A doctor may also prescribe treatment for any underlying medical conditions, such as diabetes.
The American College of Cardiology (ACC) and American Heart Association (AHA) recommend additional treatment based on how high a person’s blood pressure is.
There are two stages of high blood pressure: stage 1 high blood pressure and stage 2 high blood pressure.
Having stage 1 high blood pressure means having a top number of 130–139 over a bottom number of 80–89. Only one of these numbers needs to be high for a doctor to consider it high blood pressure.
Having stage 2 high blood pressure means having a top number of 140 or higher over a bottom number of 90 or higher.
According to the guidelines, doctors should prescribe blood pressure medication for people with stage 2 high blood pressure. They may only recommend medication for those with stage 1 hypertension if they have already had a heart attack or stroke or have other risk factors for a serious heart health issue.
The ACC and AHA guidelines also say that it is important for doctors to take socioeconomic and mental health factors, including chronic stress, into consideration when treating hypertension.
People who think that they have high blood pressure or have several risk factors for it should contact a doctor to discuss diagnosis and treatment.