Black Americans are under pressure to closely examine their heart health.
Conversations about centuries of systemic racism have continued to become more mainstream. When you understand the different barriers that Black Americans deal with, it’s not too surprising that high blood pressure is more common in this demographic than in the general population.
High Blood Pressure Is High Amongst Black Americans—Why?
What researchers do know is that many risk factors for high blood pressure are more common in Black Americans. This includes obesity (although it can be tricky to know actual obesity rates since BMI calculations don’t account for Black bodies). It also includes diabetes. Both of these conditions are linked to higher blood pressure since high blood sugar can damage blood vessels, and obesity can strain the heart muscle.
“Unfortunately, this is something that's been going on since the 1960s,” if not before, says David E. Anstey, MD, MPH, cardiologist at Columbia University’s Irving Medical Center. “We've known about this for a very long time, so it's on all of us to really start to make changes to help reduce our blood pressure and improve our health.”
Some of the risk factors for high blood pressure that are more common in Black and African Americans include:
1. Unhealthy diets
Black Americans are disproportionately more likely to live in food deserts, or communities where there is no access to a full-service grocery store that offers fresh produce. Diets centered on fast and processed food tend to be much higher in sodium than home-cooked meals. Lower-income families may rely on canned and heavily processed foods (high in sodium) or may have less access or education around the benefits of fiber-rich foods like fruits, vegetables, and whole grains.
2. Sedentary lifestyles
Being sedentary can lead to weight gain, but also on its own can lead to hypertension. With less awareness around ways to maintain heart health, Black communities may not be aware that exercise isn’t just for athletes—but that moving more is important for all individuals to strengthen their hearts, just like any other muscle. The less energy and calories people exert, the more weight they are going to gain and have to carry in their body, affecting blood pressure.
Experts classify obesity using BMI, or body mass index. Higher BMI rates among Black people might only be correlationally linked to other illnesses, rather than causationally. That’s because the BMI was developed in studying only white men. However, higher weights, body fat content, and cholesterol do strain the body.
4. Chronic stress
Dr. Anstey says that chronic stress can be uniquely common amongst African Americans. Studies show that there is a link between racial discrimination and higher blood pressure. It’s not hard to see why: Dealing with acts of racism is incredibly mentally taxing, which may take a toll on physical wellbeing as well.
This alone may affect blood pressure, but stress can also cause people to adopt unhealthy habits. Under stress, people are more likely to smoke, drink more alcohol, eat “comfort foods,” and skip exercise. These all can have an effect on heart health.
4. Lack of trust in (and access to) health care
There is a long history of white people abusing Black bodies in order to make advances in medicine. Although empathy and ethics have evolved in medicine, obstacles like finances, geography, and language barriers may still limit Black Americans’ access to health care.
“All of these factors together have sort of conspired to make this problem not just a problem the whole nation faces,” says Dr. Anstey, “but [one] we as African Americans disproportionately face and really have to work together to overcome.”
What Can You Do To Improve Your Blood Pressure?
This onslaught of hurdles is enough to spur anyone to throw their hands up in frustration and give up changing their circumstances. Still, it’s imperative that people at higher risk for high blood pressure, no matter the cause, remain vigilant.
High blood pressure is dangerous because it increases the risk of:
- Stroke (which disproportionately affects Black Americans)
- Heart failure
- Heart attack
- Kidney disease and kidney failure
- Vision loss
- Sexual dysfunction
To reduce your risk of these health issues, you can manage your blood pressure with the following:
- Manage your stress levels: Stress serves to exacerbate any issue you have. Mental health is becoming a more mainstream conversation, so it’s time to take it just as seriously as any physical injury. Find a therapist you can trust—and it’s more than OK to choose one who relates to what you are going through.
- Dig in to your family history: Knowledge is power. It’s important to know your blood pressure and your heart disease risk so you can be empowered to make the changes to lower your risk. Speak with your doctor about illnesses that people in your family, up to your great grandparents, have lived with.
- Treat your body with care and respect: Eat meals with whole foods, cook at home more regularly, start moving more, and prioritize sleep. It’s also important to stop smoking and limit your alcohol intake. Learn more about heart-healthy lifestyle changes that Black Americans can make.
If you’re worried about your blood pressure, talk to your doctor. Set a game plan together to manage your risk factors. Your doctor may have tips for how to build healthy habits despite obstacles that you may be facing. That way, you can enjoy a longer, healthier life with your loved ones (and set a good example for the next generation).
David Anstey, MD, is a cardiologist at Columbia University Irving Medical Center.
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