Key takeaways:
High blood pressure is more common, more severe, and develops at earlier ages in African Americans.
Lifestyle changes can help prevent high blood pressure and is often the first step in treating it.
The only way to know if you have high blood pressure is to check it. Current guidelines recommend yearly blood pressure screening for Black adults 18 years old and up.
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 this country.
Hypertension is very common, but in Black communities, the rates are particularly high. In the U.S., more than half of Black adults over age 20 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.
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: Both numbers are high. 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.
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 chronic diseases like hypertension in African Americans. Black people in communities that have high rates of poverty have a lack of access to health resources.
There are theories that genetics may also contribute to the higher rates of high blood pressure in Black people. Because of the physical stress of the slave trade, African Americans may have developed an ability to hold onto more salt in the body to survive extreme conditions. But in normal conditions, higher levels of salt in the body can lead to extra fluid and higher blood pressures.
What do I do if my blood pressure is too high?
If you are getting high blood pressure readings, you need to notify your healthcare provider to establish a treatment plan. If your blood pressure is elevated or in the stage 1 range, lifestyle modifications may be enough to treat it. If your blood pressure is higher than that, you may also need medication to help control your blood pressure. But even when medicine is used to treat high blood pressure, lifestyle management is still recommended.
There are some treatments that work better in Black people with high blood pressure than in others. You and your healthcare provider should discuss the best approach for you to control your blood pressure.
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What is hypertensive crisis?
A hypertensive crisis can happen when your blood pressure is greater than 180/120. This is a medical emergency that can sometimes lead to death if untreated. If your blood pressure readings are this high and you are experiencing any symptoms like chest pain, shortness of breath, vision changes, or numbness and tingling — you will need to seek medical attention immediately or call 911.
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:
Decreased libido (sex drive) and sexual dysfunction
Pregnancy complications, preterm birth, and low birth weight
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 25% 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 are not very clear. That’s why it’s important to follow the instructions of your healthcare provider closely, and follow up regularly to make sure the treatment plan you’ve made with your provider is working.
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. Current guidelines recommend yearly blood pressure screening for Black adults 18 years old and up.
For those with known high blood pressure, it will be important to monitor it more frequently. Regular monitoring will help determine if treatments are working well, or if they need to be changed for better blood pressure control. Your healthcare provider will let you know how often your treatment plan requires you to check your blood pressure.
How do I monitor my blood pressure?
You don’t have to visit a healthcare provider to check your blood pressure. Many local grocery stores or drug stores have an automated cuff where you can check it, or you can buy a blood pressure cuff for your home.
Home blood pressure monitoring is easy and convenient, but there are some steps you should follow to ensure you are getting the most accurate reading:
Make sure not to eat or drink for at least 30 minutes before your blood pressure check.
Rest quietly in a chair for at least 5 minutes before taking your blood pressure.
Sit up straight with both feet flat on the floor.
Place your arm on a table so that it’s at chest height.
Avoid talking while your blood pressure is measured.
Repeat the test at least once — 2 minutes apart — to see if the reading is consistent.
How can I prevent high blood pressure?
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.
Risk factors that can’t change
Increasing age
Race
Family history of high blood pressure
Risk factors that can change
Diet high in salt and fat
Lack of exercise
Having overweight or obesity
Smoking
Even if you have many risk factors that cannot be changed, there’s always an opportunity to maximize your health and improve your lifestyle. Here’s the good news: Limiting the risk factors that you can change significantly decreases your risk of high blood pressure.
The bottom line
High blood pressure is much more common in the African American community, and the complications of not treating it can be severe. But there are some things that you can do to decrease your risk. Monitoring your blood pressure regularly and making healthy lifestyle choices can help prevent high blood pressure and improve blood pressure control.
If you are concerned about developing high blood pressure, talk with your healthcare provider about decreasing your risk. If you are being treated for high blood pressure, regular follow-ups and monitoring can ensure your treatment plan is working.
Why trust our experts?
References
American Heart Association. (n.d.). Understanding blood pressure readings.
American Heart Association. (2016). How high blood pressure can affect your sex life.
American Heart Association. (2016). How high blood pressure can lead to vision loss.
American Heart Association. (2017). Hypertensive crisis: When you should call 911 for high blood pressure.
Appel, L. (2003). Lifestyle modification as a means to prevent and treat high blood pressure. Journal of the American Society of Nephrology.
Centers for Disease Control and Prevention. (2021). Facts about hypertension.
Centers for Disease Control and Prevention. (2021). High blood pressure during pregnancy.
Centers for Disease Control and Prevention. (2021). Measure your blood pressure.
Cooper, R., et al. (2015). Elevated hypertension risk for African-origin populations in biracial societies: Modeling the epidemiologic transition study. Journal of Hypertension.
Fuchs, F. (2011). Why do Black Americans have higher prevalence of hypertension? Hypertension.
Lackland, D. (2014). Racial differences in hypertension: Implications for high blood pressure management. The American Journal of the Medical Sciences.
U.S. Preventive Services Task Force. (2021). Hypertension in adults: Screening.
Zilbermint, M., et al. (2019). Genetics of hypertension in African Americans and others of African descent. International Journal of Molecular Sciences.
