High blood pressure, or hypertension, affects about one in three adults in the United States. The rate is closer to 40 percent for African Americans. High blood pressure may develop earlier in life and be more severe if you are African American.
Early deaths related to high blood pressure complications are greater for non-Hispanic blacks even with treatment. High blood pressure complications include:
- Kidney failure
- Heart disease
High blood pressure doubles the risk of stroke in African Americans compared to other ethnic groups.
Why a higher risk?
It's not clear why African Americans are more at risk for high blood pressure. There could be several contributing factors. This population group has a higher rate of diabetes and obesity. Those diseases increase the risk for high blood pressure. Research also indicates that a gene may make African Americans more sensitive to sodium (salt), which may raise their blood pressure levels.
African Americans tend to respond differently to some blood pressure medications than do Hispanics and Caucasians. This factor may call for several treatments to be used in combination. In general, African Americans have a harder time reaching their targeted control levels even with treatment.
What is blood pressure?
Blood pressure measures the force of blood on the inside of the arteries as the heart pumps and rests between beats. Blood pressure is at its highest when your heart contracts. This is called systolic blood pressure. Between heartbeats, when your heart rests, your blood pressure drops. This is called diastolic blood pressure. The top number in your blood pressure reading is your systolic number and the bottom number is the diastolic.
Blood pressure can vary during the day. It can go up when you are active, excited or nervous. It tends to go down when you are at rest.
What is considered high blood pressure?
Blood pressure of 120 or lower on the top reading and 80 or lower on the bottom is considered normal. A systolic (top number) reading of 120 to 139 or a diastolic (bottom number) of 80 to 89 indicates prehypertension. This means you're at risk of developing high blood pressure if steps are not taken to prevent it. A systolic reading of 140 or higher or a diastolic reading of 90 or greater means you have hypertension.
High blood pressure is defined differently for those with diabetes or chronic kidney disease. In those cases, 130 over 80 or higher is considered high. The numbers also differ for teens and younger children. Some experts recommend that certain African Americans start getting treatment if their blood pressure is greater than 135 over 85.
High blood pressure is diagnosed over time. One high reading does not necessarily mean you have hypertension. You may be asked to return to the clinic to have more pressure readings taken before a diagnosis is made.
If you have hypertension or prehypertension, your doctor may recommend lifestyle changes. These might include:
- Reducing the amount of sodium in your diet
- Eating more healthy foods
- Exercising more
- Losing weight, if you're overweight
Your doctor may also prescribe one or more medications to get your blood pressure under control.
How is hypertension treated?
The same things that help prevent high blood pressure can help treat it. Experts advise you to:
- Limit sodium intake to less than 1,500 milligrams (two thirds of a teaspoon) per day.
- Exercise at least 150 minutes a week at moderate intensity, even if it's just for 10 minutes at a time. Try to work in at least two days a week of strength-building exercises.
- Lose weight, if you are overweight.
- Quit smoking, if you smoke.
- Limit your alcohol intake. For women, this means no more than one drink a day. Men should have no more than two drinks a day.
- Manage stress. Stress can cause your blood pressure to rise.
- Take medication as prescribed by your doctor.
If you have high blood pressure, it's important to see your doctor regularly to monitor and manage it, and to follow a healthy lifestyle. High blood pressure can be managed to help reduce your risk of complications and early death.
Created on 03/19/2007
Updated on 09/17/2013
- UpToDate. Treatment of hypertension in blacks.
- National Heart, Lung, and Blood Institute. National Institutes of Health. High blood pressure. What is high blood pressure?
- National Heart, Lung, and Blood Institute. National Institutes of Health. High blood pressure. Who is at risk for high blood pressure?
- National Heart, Lung, and Blood Institute. Your guide to lowering high blood pressure.