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The pressure of hypertension among African-Americans


One August night in 2011, Richard Horton woke up feeling strange. As he got up and stumbled across the room, he walked into a wall. The health insurance broker thought he might be having a stroke, but he quickly brushed it off and went back to bed.

Unknown to Horton, years of uncontrolled high blood pressure had wreaked havoc on his blood vessels, causing a hemorrhagic stroke — that’s when a weakened blood vessel ruptures. While recovering in the hospital, he suffered another stroke. Fully-paralyzed, Horton had to learn how to walk and talk again.

A healthy blood pressure is less than 120/80. The higher a person’s blood pressure is, the more forcefully blood is pumping through the blood vessels. As the workload increases, the force and friction of high blood pressure damages the delicate tissues inside the arteries.

Over time and left untreated, high blood pressure can lead to life-threatening problems, including heart attack and stroke. People with hypertension also have an increased risk of serious complications and even death from COVID-19.

Nearly half of U.S. adults have high blood pressure, but the burden of disease is disproportionately higher in Black people, who have among the highest rates of hypertension in the world. Additionally, high blood pressure develops earlier in life and is usually more severe in this community.

While lifestyle factors, such as an unhealthy, high-sodium diet, smoking and physical inactivity, increase the risk of high blood pressure, the American Heart Association (AHA) states that structural discrimination contributes to inequities in access, use and quality of health care, leading to the disproportionate burden of cardiovascular risk factors, including high blood pressure, in communities of color.

Every person deserves the opportunity for a full, healthy life and the American Heart Association believes that heart and brain health for all cannot be achieved without addressing uncontrolled high blood pressure and the structural inequities that make healthy choices difficult for many.

The Association has made a commitment to eliminate uncontrolled high blood pressure, focusing on identifying and removing these health barriers.

Aimed specifically at reducing hypertension as a health disparity in Los Angeles County’s African American community, the American Heart Association and Providence have collaborated to enable community organizations, faith-based groups, and workplace settings to teach its members how to self-monitor and manage their blood pressure, as well as how to seek medical care.

The effort is complemented by on-demand health lessons where people learn simple steps to keep their blood pressure healthy and prevent cardiovascular disease.

The AHA is also working with outpatient clinics, including Federally Qualified Health Centers, and equipping them with the tools and resources to empower more than 900,000 patients in LA’s under-resourced communities to self-measure and manage their blood pressure. This includes providing complimentary self-monitoring blood pressure cuffs to patients and giving clinicians access to evidence-based strategies from the Association’s Target: BP initiative, which informs the way health care teams assess and categorize levels of blood pressure, determine cardiovascular disease risk and guide hypertension management.

The lack of diverse representation in the medical field is another crucial factor that needs to be addressed. That is why the AHA established the Historically Black Colleges and Universities Scholars Program to increase the number of Black students who apply and are accepted into graduate science, research and public health programs.

In 2019, only 7 percent of medical students and 6 percent of med school graduates in the U.S. were Black. Underrepresented medical professionals are more likely to practice in their communities where cultural sensitivity can create trust and improve outcomes.

After his stroke, Horton made significant lifestyle changes.

“I haven’t taken backward steps. I changed the way I eat, and I have a better understanding of how certain foods affect my health,” he said. “I exercise regularly, adhere to prescribed medication and I have a BP monitor at home to stay on top of my blood pressure.”

The American Heart Association recommends home monitoring for all people with high blood pressure, and it is important to know how to do it correctly. To learn how to monitor your BP at home and prevent and manage hypertension, go to