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Researchers would like to examine what kinds of stress may trigger high blood pressure in African Americans, and what can be done to counteract it. Getty Images
  • Researchers say stress may be a major factor in the high rate of high blood pressure among African Americans.
  • The researchers studied more than 1,800 participants in a heart study in Jackson, Mississippi.
  • One expert said the research is important, but he’d like to examine what kinds of stress are involved and whether people are doing anything to reduce their anxiety and tension.

More than 40 percent of African Americans have high blood pressure, according to the American Heart Association.


The theories range from higher rates of diabetes and obesity to a gene that may make African Americans more sensitive to salt.

A new study published in the Journal of the American Heart Association (JAHA) suggests there could be another reason.

High levels of chronic stress.

“This is a significant finding, because African Americans have higher rates of hypertension and heart disease compared with other racial and ethnic groups,” said Tanya Spruill, PhD, lead author of the study and an associate professor of population health and medicine at the New York University School of Medicine.

The team of researchers analyzed data from 1,829 participants in the Jackson Heart Study, a large community based sampling of African Americans living in Jackson, Mississippi.

The participants didn’t initially have high blood pressure.

The group had home visits, clinic exams, and annual follow-up phone calls. They were asked how much stress they had experienced in the past year and to rate it on a 6-point scale, ranging from “none” to “extreme stress.”

The researchers found that participants who reported high stress levels over time had a 22 percent increased risk for developing high blood pressure compared with those who reported sustained low stress levels.

The link to blood pressure was independent of sociodemographic factors, traditional risk factors, or health behaviors.

“Our results showed that sustained high stress over time increased the risk of developing hypertension,” Spruill told Healthline. “This highlights the need for new hypertension strategies for African Americans.”

Spruill says the researchers didn’t determine whether that stress included racism, discrimination, inequality, or other stressors that may affect African Americans.

“We did not examine this. The stress measure used in this study assessed overall perceived stress, which could reflect any of those sources of stress as well as others,” she explained.

“Because this is an observational study, we interpret the findings cautiously,” Spruill added. “Next steps include conducting a clinical trial to test whether stress management can lower blood pressure and prevent or delay the onset of hypertension.”

Clyde W. Yancy, MD, is a former president of the American Heart Association. He’s currently the vice dean for diversity and inclusion and the chief of cardiology in the department of medicine at Northwestern University’s Feinberg School of Medicine in Illinois.

“This is one of the few reports we’ve seen where stress, per se, was the measurement in question. The authors did something that was very straightforward, using a single question over time, and it could be considered brilliant,” he told Healthline.

“It may not seem like a eureka moment,” Yancy added, “but it’s one of the few times we’ve been able to calibrate what is the contribution of stress to the likelihood of something as important as high blood pressure.”

However, Yancy says he has questions that need to be examined further.

“What was the definition of stress? Was it a stressful relationship? Was it a stressful job situation? Was it a stressful life experience? Was it some kind of economic stress? How did that person identify stress?” he said.

“Did that person try to do anything to handle the stress? Counseling? Group therapy? Talking with family members? We don’t know if the stress itself was acted upon in any meaningful way.

“You do wonder in studies like this, is it still possible, despite very good efforts done by very good investigators, whether there were other explanations that simply could not be uncovered?” Yancy said.

Yancy feels there are some practical applications that can come out of the study.

“This is a tantalizing new direction to consider, in part because there are ways to deal with stress, like behavioral therapy and counseling,” he said.

“This report really brings our attention back to the central focus. Everyone, especially if you’re African American, should know your numbers and get your blood pressure checked,” Yancy said.

He adds lifestyle changes can work. If they don’t, your doctor may prescribe medications.

“Given we’re still trying to understand the whys, let’s focus on the hows right now,” Yancy said.