Table of ContentsView AllTable of ContentsRace and High Blood PressureHeart Disease RiskDisparitiesTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Race and High Blood Pressure
Heart Disease Risk
Disparities
Treatment
Frequently Asked Questions
This article is part ofHealth Divide: Heart Disease Risk Factors, a destination in our Health Divide series.
Disparities in housing, employment, and health care have contributed to poor health in racial and ethnic minority communities. This can increase the likelihood of developinghypertension(high blood pressure), which can then increase the risk of heart disease.
Even more, historically marginalized groups like Black people have a harder time accessing high-quality medical care when they need it, underscoring the importance of preventing chronic diseases such as hypertension before they begin.
Zoe Hansen / Verywell
High blood pressure can thicken the arteries, causing undue stress on the heart and blood vessels. Over time, the heart must work harder and harder to overcome this pressure until it eventually gives out.
This article addresses howhigh blood pressure increases heart disease riskin Black people.
What Is Considered High Blood Pressure?Blood pressure consistently above 130/80 millimeters of mercury (mmHg) is considered high.
What Is Considered High Blood Pressure?
Blood pressure consistently above 130/80 millimeters of mercury (mmHg) is considered high.
High blood pressure is one of the most common causes of heart disease in the Black community.
Still, these numbers are likely an underestimation due to a lack of access to care (and some reluctance to seek care even when it is available), low socioeconomic status, and lower health literacy rates (the degree that people have the capacity to obtain, process, and understand health information).
Why High Blood Pressure Is a Risk Factor for Heart Disease
High blood pressure levels over a long period of time can thicken your heart muscle and blood vessels, changing the structure and function of these tissues and putting you at risk of heart failure.
High blood pressure not only damages the heart but may also affect other organs of the body—like the kidneys, brain, and liver—putting even more stress on the body and further exacerbating (worsening) your high blood pressure.
Even at chronically high levels, high blood pressure can show little or no symptoms, which is why it is often referred to as “the silent killer.”
In fact, some people are unaware that they have high blood pressure and only find out after it’s too late. This underlines the importance of:
Underlying Cause of High Blood Pressure Disparities
The causes of ethnic and racial inequalities that give rise to high blood pressure disparities are complex.
Prevalence of High Blood Pressure in Black PeopleBlack people are 40% more likely to have high blood pressure than White people.
Prevalence of High Blood Pressure in Black People
Black people are 40% more likely to have high blood pressure than White people.
Factors that likely contribute to such a disparity in high blood pressure for Black people include:
Additionally, evidence suggests that the longer immigrants of any race live in the United States, the more likely they are to develop high blood pressure.
One major culprit of high blood pressure that may explain this phenomenon is the adoption of the Southern diet—one that includes a high intake of fried foods, organ meats, processed meats, eggs, egg dishes, added fats, high-fat dairy foods, sugar-sweetened beverages, and bread.
Not only has this been identified as a key reason for the racial gap in high blood pressure, but it also helps to explain the heart disease disparities that are seen among Black people who live in the South compared to other parts of the country.
Of note, gaps exist in the medication compliance (how well a person adheres to taking their prescriptions on time, at the right dose, and at the correct frequency) of antihypertensive therapies (blood pressure medication)—they are highest for non-Hispanic whites and lowest for Hispanics, with Black people falling in between.
The Link Between Stress, Racism, and High Blood PressureRacism is a special kind of stress that impacts Black people in a myriad of ways, including raising blood pressure.Repeated exposure to discrimination and systemic inequity (unfairness within the system) is associated with biological aging of the cells, a phenomenon calledbiological weathering, which leads to genetic changes that age and lower the functioning of cells.
The Link Between Stress, Racism, and High Blood Pressure
Racism is a special kind of stress that impacts Black people in a myriad of ways, including raising blood pressure.Repeated exposure to discrimination and systemic inequity (unfairness within the system) is associated with biological aging of the cells, a phenomenon calledbiological weathering, which leads to genetic changes that age and lower the functioning of cells.
Racism is a special kind of stress that impacts Black people in a myriad of ways, including raising blood pressure.
Repeated exposure to discrimination and systemic inequity (unfairness within the system) is associated with biological aging of the cells, a phenomenon calledbiological weathering, which leads to genetic changes that age and lower the functioning of cells.
Other Risk Factors
The following lifestyle choices and behaviors increase your risk of being diagnosed with high blood pressure:
A normal blood pressure for an adult is less than 120/80 (120 over 80) mmHg. This means that the top number, called the systolic blood pressure, averages less than 120 mmHg, and the bottom number, your diastolic blood pressure, averages less than 80 mmHg.
If your systolic blood pressure is between 120 mmHg and 129 mmHg or your diastolic is higher than 80 mmHg, you are at risk of developing stage 1 or stage 2 hypertension.
An Integrative Treatment Approach
High blood pressure is something you can treat.
Below are treatment options for high blood pressure that you could discuss with your healthcare provider.
How High Blood Pressure Is Treated
Medication
The four most common types of hypertension medication are:
These are equally effective in lowering blood pressure, but recent research shows that ARBs and ACE inhibitors may not be as effective in Black people.
Therefore, Black Americans with stage 1 hypertension are generally started on a thiazide diuretic or calcium channel blockers. Why some drugs are more or less effective in some racial and ethnic groups remains a mystery.
Lifestyle
Combining medication with diet, exercise, and lifestyle changes is the best way to achieve long-term blood pressure control and keep those levels at a healthy range.
The following lifestyle behaviors not only mitigate acute high blood pressure but may also be preventive in nature if started early:
All high blood pressure medications have side effects. Be sure to discuss what they are with your healthcare provider before starting on one and always take your medication as prescribed.
Stress Management
Chronic stress can damage your heart over time. Like high blood pressure, it is a silent killer in and of itself. Even more, high levels of stress are associated with poor health habits like:
Limiting stress has immeasurable value in preventing hypertension.
Taking breaks at work, talking to supportive friends, eating healthy, and going for a run after work or school are some ways that you can manage your stress.
The goal isn’t to avoid stress at all costs—that’s nearly impossible to do—but to find ways to address stressful situations in a healthy way and limit the amount of negative stress that you experience in your life.
Even more, working with a healthcare professional and/or a therapist can help you meet your heart health and blood pressure goals.
Summary
High blood pressure is a major risk factor for heart disease in Black people.
High blood pressure disparities exist for a wide range of reasons, but differences in socioeconomic status, substandard insurance coverage, and poor access to health care are the primary determinants of disparities associated with poor high blood pressure control.
Still, there is no definitive answer for why high blood pressure is more common and more severe in Black people, but it’s likely that genetics and your environment play a role.
A Word From Verywell
High blood pressure in the Black community is well-documented, and there are several innovative projects that have shown significant and sustained improvements in blood pressure control.
Lessening the racial-wealth gap and funding large-scale research projects that effectively recruit Black people are key to reversing the current trends in high blood pressure, which is serving as a silent killer in the Black community.
Frequently Asked QuestionsNational surveys and large-scale studies have consistently found that Non-Hispanic Blacks (NHB) have significantly higher rates of hypertension compared to non-Hispanic Whites (NHW). Of note, Latinx and non-Latinx Asians (NHA) have lower rates than both groups.Black people in the United States are more likely to experience systemic racism and institutional inequality that results in substandard insurance coverage and poor access to health care. This can lead to poor high blood pressure control.High blood pressure gradually remodels the heart and blood vessels and damages other organs, putting excess stress on the heart.Black healthcare providers are more likely to provide culturally specific care—listening to their patients' concerns and empathizing with their plights. Two places Black people can find Black providers areBlackdoctor.organdFindABlackDoctor.com.It must be noted that working with any provider, regardless of race, who can provide culturally competent care is much better than delaying care. Putting off care in search of finding the perfect Black provider is never recommended.
National surveys and large-scale studies have consistently found that Non-Hispanic Blacks (NHB) have significantly higher rates of hypertension compared to non-Hispanic Whites (NHW). Of note, Latinx and non-Latinx Asians (NHA) have lower rates than both groups.
Black people in the United States are more likely to experience systemic racism and institutional inequality that results in substandard insurance coverage and poor access to health care. This can lead to poor high blood pressure control.
High blood pressure gradually remodels the heart and blood vessels and damages other organs, putting excess stress on the heart.
Black healthcare providers are more likely to provide culturally specific care—listening to their patients' concerns and empathizing with their plights. Two places Black people can find Black providers areBlackdoctor.organdFindABlackDoctor.com.It must be noted that working with any provider, regardless of race, who can provide culturally competent care is much better than delaying care. Putting off care in search of finding the perfect Black provider is never recommended.
Black healthcare providers are more likely to provide culturally specific care—listening to their patients' concerns and empathizing with their plights. Two places Black people can find Black providers areBlackdoctor.organdFindABlackDoctor.com.
It must be noted that working with any provider, regardless of race, who can provide culturally competent care is much better than delaying care. Putting off care in search of finding the perfect Black provider is never recommended.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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