High Blood Pressure and African Americans

High blood pressure (hypertension) is a common problem in the U.S. It's even more common in African Americans than among other ethnic groups. The rate of high blood pressure in African Americans is among the highest of any ethnic group in the U.S.

African Americans are at a higher risk for high blood pressure. They also get it at a younger age and have more of the complications. The problem isn't limited to just adults. African-American teens and preteens who are people of size may also develop high blood pressure.

High blood pressure can affect your health in major ways. It is a main risk factor for health problems that can cut your life short, such as:

• Heart disease

• Blood vessel disease

• Kidney disease

• Stroke

High blood pressure also causes many other problems, including erectile dysfunction and vision loss. But high blood pressure can be controlled and possibly prevented.

What is high blood pressure?

Blood pressure is the push of blood against the walls of your arteries. Blood pressure depends on two things: how hard your heart pumps the blood and the amount of resistance in your arteries to blood flow. Blood pressure is recorded as two numbers. The systolic pressure is the top number. This is the pressure against artery walls as the heart beats. The bottom number is the diastolic pressure. This is the pressure against artery walls as the heart relaxes between beats. Both numbers are important to tell if your blood pressure is too high.

Experts don't know why most people get high blood pressure. Certain risk factors, however, make it more likely. Some factors can’t be changed, but others can. These are the risk factors for high blood pressure:

• Age. The risk for high blood pressure increases with age.

• Being assigned male at birth. This gives you a greater risk of developing high blood pressure earlier in life.

• Family history. This means that you have blood relatives who have high blood pressure.

• Smoking

• Being a person of size

• Alcohol. The risk goes up for anyone drinking more than average, which is:

  • 2 drinks per day for people assigned male at birth

  • 1 drink per day for people assigned female at birth

• Too little exercise. The advised amount of exercise is an average of 30 to 40 minutes of moderate- to high-intensity activity 4 to 5 days a week.

• Sensitivity to salt (sodium). In some people, eating too much salt leads to high blood pressure.

• Type 2 diabetes, gout, or kidney disease

• Pregnancy. Some people who don't have high blood pressure get it during pregnancy.

• Certain medicines or herbal supplements. Taking certain medicines and herbal supplements can raise blood pressure in some people. Common ones include steroids, ibuprofen, and diet pills.

• Using illegal drugs such as cocaine and amphetamines

• Untreated obstructive sleep apnea

• High thyroid levels (hyperthyroidism)

Why are the risks higher?

It was once thought that certain genetic and biological differences caused the risk to be greater in African Americans. Experts are now looking into how socioeconomic disadvantages and lifestyle factors may add to these risks. African Americans are more likely to:

• Be sensitive to the effects of salt on blood pressure

• Have blood vessels that are more sensitive

• Be people of size

• Have higher rates of diabetes compared with non-Hispanic whites

Other things that may make up for the difference in high blood pressure risk are:

• Less access to healthcare and healthcare information

• Lower levels of education and income

• Lack of resources for a healthy lifestyle

• Stressful lifestyle from things such as unemployment and living in neighborhoods with noise, violence, and poverty

• Smoking

• Diets high in salt, fat, and sugar, and low in vegetables and fiber

Many people are not aware of the dangers of high blood pressure. Mild to moderate high blood pressure usually does not cause symptoms. But early treatment of high blood pressure helps prevent complications that may cut your life short. Anyone with any of the following health problems should have their blood pressure checked at least once a year:

• Has blood relatives who have had a stroke, heart attack, high blood pressure, or kidney disease

• Has type 2 diabetes

• Is a person of size

Change your lifestyle

If you have high blood pressure, you can lower your blood pressure by making changes in your lifestyle. Your healthcare provider can help you find what changes you need to make and how to make them.

These are the basics of a healthy lifestyle:

• Don't smoke or quit smoking.

• Keep yourself at a healthy weight, or a body mass index below 25.

• Get at least 30 to 40 minutes of moderate to vigorous exercise most days.

• Buy low-salt or salt-free foods, and use little or no table salt.

• Eat 2 cups of fruit and 2.5 cups of different colored vegetables a day.

• Eat fewer foods from animals to avoid saturated fat.

• Use only nonfat or low-fat dairy products.

• Drink fewer sugary drinks.

• Limit how much alcohol you drink. This means:

  • No more than 2 drinks a day for people assigned male at birth

  • No more than 1 drink a day for people assigned female at birth

• Don't use recreational or illegal drugs that may increase blood pressure.

• If you snore, find out if you have sleep apnea. If you do, wear your CPAP mask to sleep. Follow your sleep specialist's advice.

If lifestyle changes don't lower your blood pressure enough, then you may need to take medicine. Often people need to take several different medicines to drop their blood pressure to a normal level. Two types of medicines seem to work better at lowering blood pressure among African Americans. These are thiazide diuretics and long-acting calcium channel blockers. Treating other chronic health problems, such as type 2 diabetes, is also important.