Hypertension, or high blood pressure, happens when blood pressure levels remain elevated. According to the Centers for Disease Control and Prevention (CDC), roughly 47 percent of adults in the United States have hypertension.

Although high blood pressure can affect adults of all racial and ethnic backgrounds, hypertension is more common in African Americans.

In fact, the American Heart Association estimates that more than 40 percent of Black men and women in the United States have hypertension.

In this article, we’ll discuss the risk factors of hypertension, why it’s more prevalent in Black people, and how to treat and prevent this condition.

In 2017, the American College of Cardiology and other major health organizations released guidelines for the prevention, diagnosis, and management of high blood pressure in U.S. adults.

According to statistics released within the guidelines, roughly 54.9 percent of non-Hispanic Black adults in the United States met the criteria for high blood pressure.

In comparison, only 47.3 percent of non-Hispanic white adults met the criteria for hypertension, followed by 36.7 percent of non-Hispanic Asian adults and 34.4 percent of Hispanic adults.

In addition to having higher rates of hypertension, non-Hispanic Black adults were also found to have higher rates of uncontrolled hypertension.

Even among adults who were taking high blood pressure medications, roughly 63 percent of non-Hispanic Black adults still had blood pressure levels above treatment goals — versus only 50.6 percent of non-Hispanic white adults.

Hypertension is believed to be more common in Black Americans due to disparities in social, economic, and health factors.

In 2010, the CDC published a review of the psychosocial factors that contribute to the increased rate of high blood pressure levels in Black men.

Although the report itself widely references Black men specifically, many of these factors affect the Black population in general.

Social factors

Research has suggested a link between racism and race-based discrimination to high blood pressure levels.

Perceived racism often leads to both increased stress and lower self-esteem, both of which can lead to higher blood pressure levels.

In addition, personal beliefs and attitudes about health conditions can impact the diagnosis and treatment of conditions like hypertension.

Factors such as age, socioeconomic status, and education level all have an impact on the health outcomes of Black Americans with hypertension.

Economic factors

Socioeconomic differences have a known impact on healthcare outcomes, especially for people with lower socioeconomic status.

In one 2004 study, researchers found that socioeconomic status was more strongly associated with hypertension in Black Americans than white Americans.

Economic inequality can also lead to poorer healthcare outcomes, which have a significant negative impact on disease and death rates.

Lack of health insurance coverage, healthcare accessibility, and cultural understanding may all play a role in the increased rate of hypertension in Black Americans.

Health factors

Some other health conditions you may have can put you at higher risk of chronic conditions such as hypertension.

For example, an increased rate of obesity in African American men is strongly linked to an increased risk of developing high blood pressure.

Ultimately, many factors play a role in the increased rates of hypertension in Black Americans, especially Black men. However, more research is needed to determine how to better identify and address these risk factors for current and future populations.

Hypertension can often remain undiagnosed for years without producing symptoms. This is why it’s important to have your blood pressure checked regularly.

In rare cases, severe hypertension may cause the following symptoms:

  • severe headache
  • severe anxiety
  • dizziness
  • chest pain
  • vision changes
  • shortness of breath
  • nosebleed

Get immediate medical care if you have these symptoms.

If you’ve received a diagnosis of high blood pressure, treatment options may include lifestyle changes, medications, or a combination of both.

Medications

Many medications for hypertension treat elevated blood pressure levels by helping dilate, or relax, the blood vessels.

Here is an overview of some common medications for treating hypertension:

  • Diuretics. Diuretics work to reduce both blood volume and blood pressure by helping the kidneys excrete water and salt.
  • Alpha- and beta-blockers. Beta-blockers reduce the speed and force of the heart, which reduces blood flow and pressure. Alpha-beta-blockers prevent the blood vessels from narrowing, which improves blood pressure levels.
  • Angiotensin inhibitors and blockers. Angiotensin converting enzyme (ACE) inhibitors reduce the production of the hormone that narrows blood vessels. Angiotensin II receptor blockers (ARBs) block the receptors that accept this hormone, which helps improve blood flow and blood pressure.
  • Alpha-blockers and agonists. Alpha-1 blockers prevent the blood vessels from narrowing by blocking the receptors from accepting certain hormones. Alpha-2 receptor agonists prevent blood vessel narrowing by blocking the production of adrenaline.
  • Calcium channel blockers. Calcium channel blockers reduce the strength of the heart’s contraction and allow blood vessels to relax, which in turn lowers blood pressure.
  • Vasodilators. Vasodilators help dilate the blood vessels to allow for increased blood flow, which helps keep blood pressure levels low.

Lifestyle factors

Certain lifestyle habits are often used in combination with medication to treat high blood pressure. In some cases, these changes may be enough to lower blood pressure levels without medication.

These changes include things like:

Although there are many factors that affect your risk of developing hypertension, the following habits can help reduce your risk of developing high blood pressure:

  • Maintain a moderate weight. Weight is not the only indicator of health. However, overweight and obesity can increase the risk of developing hypertension.
  • Eat a balanced diet. Eating a diet filled primarily with whole grains, fruits, vegetables, lean meats, and potassium-rich foods can help reduce the risk of hypertension.
  • Watch your salt intake. Sodium has a negative effect on blood pressure, so the American Heart Association recommends limiting sodium intake to 1,500 milligrams per day. Increasing potassium can also help excrete excess sodium from the body.
  • Increase your physical activity. When possible, aim for at least 150 minutes of moderate-intensity physical activity per week to reduce the risk of hypertension.
  • Limit your alcohol intake. If you drink, avoid having more than one to two drinks per day. If you smoke, consider working with a doctor to help you quit.

Hypertension is one of the most common health conditions in the United States. It affects millions of adults across the country.

While hypertension can affect anyone of any race or ethnicity, it disproportionately affects African American men and women.

Social, economic, and health-related factors all play a role in the increased prevalence of chronic conditions, like hypertension, in Black Americans.

If you’re concerned about your own risk of hypertension, schedule an appointment with a healthcare professional to discuss your concerns and create a prevention or treatment plan.