Why High Blood Pressure in African Americans Matters

Hypertension — also known as high blood pressure — happens when the force of blood traveling through the blood vessels is higher than it should be. Over time, this causes damage to the blood vessels and the organs they carry blood to. High blood pressure increases your risk of heart disease and stroke, which are leading causes of death in the U.S.

High blood pressure is very common. But in Black communities, the rates are particularly high. In the U.S., nearly 6 in 10 Black adults over age 18 have high blood pressure. For some, diet and exercise will be enough to keep blood pressure levels in the normal range. Others will need medication to prevent serious complications of high blood pressure. 

Why are African Americans more prone to high blood pressure?

It isn’t entirely clear why the rates of high blood pressure are higher in Black communities. There are many social and economic factors that may increase the risk of hypertension in African Americans. These may include:

• High rates of poverty

• Lack of access to health resources

• Lack of access to fresh foods and nutritious options

• Fewer community resources for parks, playgrounds, and safe exercise spaces

• High rates of stress from racism and other social pressures

There are theories that genetics may also contribute to the higher rates of high blood pressure in Black people. But studies show that Black adults who don’t live in the U.S. have similar rates of high blood pressure as white adults. 

So, social factors more likely explain why rates of high blood pressure are so much higher for Black adults in the U.S. than race.

Is high blood pressure worse in Black people?

In general, Black people tend to have higher blood pressure, more complications, and develop it at much earlier ages than other groups. The rates of African Americans with high blood pressure who have it under control — either through lifestyle changes or medication — are also low. Only 31% of African Americans who have been prescribed medication to treat their blood pressure have gotten their blood pressure in the normal range. 

The reasons why these differences exist aren’t very clear. That’s why it’s important to follow the instructions of a trusted healthcare professional closely and to follow up regularly. This will help to make sure the treatment plan you’ve made together is working.

How would I know if I have high blood pressure?

There are generally no symptoms of high blood pressure. So you can go many years without knowing that you have high blood pressure. This is why it’s often called the “silent killer.” The only way to tell if your blood pressure is high is to check it.

What’s a normal blood pressure reading vs. high blood pressure reading?

Your blood pressure is made up of two numbers. The top number is known as the systolic blood pressure, and the bottom number is known as the diastolic blood pressure. Both numbers are important. Here’s how to interpret a blood pressure measurement:

• Normal blood pressure: Both numbers are normal. Systolic is below 120 mmHg and diastolic is below 80 mmHg.

• Elevated blood pressure: Systolic is above 120 but less than 130 mmHg, and diastolic is normal (below 80 mmHg).

• Hypertension: In stage 1 hypertension, systolic is 130 to 139 mmHg, or diastolic is 80 to 89 mmHg. In stage 2, systolic is at least 140 mmHg, or diastolic is 90 mmHg or higher.

• Severe hypertension/hypertensive emergency: Systolic is higher than 180 mmHg, or diastolic is higher than 120 mmHg.

What do I do if my blood pressure is too high?

If you’re getting high blood pressure readings, you need to let a healthcare professional know so you can establish a treatment plan. 

For elevated or stage 1 high blood pressure, lifestyle changes may be enough to treat it. These include:

• Dietary changes (low salt, low fat, or the DASH diet)

• Increasing your physical activity

• Managing your weight

• Decreasing alcohol intake

• Quitting smoking

• Improving sleep

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If your blood pressure is higher than that, you may also need medication to help control your blood pressure in addition to lifestyle changes. The good news is that there are many different types of blood pressure medications to choose from. 

Medications that are considered first-choice options for people with high blood pressure include:

• Thiazide diuretics (a type of “water pill”)

• Angiotensin-converting enzyme (ACE) inhibitors

• Angiotensin II receptor blockers (ARBs)

• Calcium channel blockers

You and a healthcare professional should discuss the best treatment approach based on how high your blood pressure readings are and your medical history.

Quiz: Am I at risk for high blood pressure?

What are some of the health effects of high blood pressure?

If not treated, high blood pressure increases the risk of other serious health problems. The increased pressure can damage and narrow blood vessels. This leads to decreased blood flow to important organs and tissues. Common complications of untreated high blood pressure include:

• Stroke 

• Blindness

• Heart attack and heart disease

• Kidney disease

• Peripheral artery disease 

• Erectile dysfunction (ED)

• Decreased libido (sex drive) and sexual dysfunction

• Pregnancy complications, preterm birth, and low birth weight

Do I need to monitor my blood pressure?

There are no symptoms of high blood pressure. So, the only way to know if your blood pressure is high is to monitor it. African Americans often develop high blood pressure at earlier ages, so it’s important to check it early. Current guidelines recommend yearly blood pressure screening for Black adults ages 18 and up.

If you know that you have high blood pressure, it’s important to monitor it more frequently. Regular monitoring will help determine if treatments are working well — or if they need to be changed to manage your blood pressure more effectively. Your healthcare team will let you know how often your treatment plan requires you to check your blood pressure. 

How to prevent high blood pressure in African Americans

There are certain risk factors that can make it more likely for you to develop high blood pressure or make it more difficult to treat. These include some risk factors that you can change and some that you may be stuck with. These factors aren’t unique to African Americans and apply to anyone.

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Written by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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