Why It Starts Earlier, and What You Can Do About It

By Nelius W.K, AGACNP-BC, Nurse Practitioner and Founder of Suilen Health. Health education only; this does not replace advice from your own clinician.

If you are a Black adult and your blood pressure runs high, you are not doing something wrong. You are dealing with one of the most common and most undertreated health problems in our community. The good news is that blood pressure is also one of the most controllable.

How common is it?

About 55% of Black adults in the United States have high blood pressure, according to the American Heart Association. That is among the highest rates in the world.

It also tends to show up sooner. Research published in JAMA Cardiology found that Black adults are diagnosed four to five years earlier on average than white adults, and about one in four is diagnosed at age 30 or younger. A long-running study called CARDIA found that roughly three in four Black adults had developed high blood pressure by age 55.

Why does it matter so much?

High blood pressure rarely hurts at first. Over the years it strains the heart, kidneys and blood vessels in the brain. Research in the journal Hypertension found that high blood pressure accounts for about half of the excess stroke risk in Black adults, and that stroke in young adults is almost four times more common in Black adults than in white adults.

That is why catching it early and keeping it controlled is worth the effort.

What is the goal number now?

The 2025 American Heart Association and American College of Cardiology guideline continues to set the treatment goal at below 130/80 for most adults. Ask your clinician what your personal goal should be.

The guideline also puts more weight on checking your pressure at home. Readings in the doctor’s office can run high from stress or rushing, and readings at home show the real pattern.

Five steps to take this month

1. Check your pressure at home. Use an upper-arm cuff that has been validated for accuracy (the AHA keeps a list at validatebp.org). The guideline advises against wrist, smartwatch or cuffless devices for diagnosing or managing high blood pressure. Sit quietly for five minutes, feet flat, arm supported at heart level. Take two readings a minute apart, morning and evening, for a week before your appointment.

2. Write the numbers down. A simple log you can hand to your clinician is worth more than a good memory.

3. Lower the salt without losing the flavor. Most sodium comes from packaged and restaurant food, not the salt shaker. Season with garlic, onion, peppers, lemon, vinegar and herbs. Rinse canned beans and vegetables. Read labels on deli meats, canned soups, seasoning blends and frozen meals.

4. Add potassium-rich foods. Greens, sweet potatoes, beans, bananas and tomatoes help balance sodium. Check with your clinician first if you have kidney disease or take certain medicines.

5. Take your medicine as prescribed, and speak up. If a pill causes side effects, or cost is a problem, tell your clinician. There are many options, and for higher readings the 2025 guideline recommends starting with a two-medicine combination in one pill, which can be simpler to take.

Questions to bring to your next visit

What is my goal blood pressure?
Should I have my kidneys checked (a urine test called UACR)?
Is my medicine the right one for me, and are there lower-cost options?
How often should I check at home and when should I call you?

When to get urgent help

Call 911 for a reading of 180/120 or higher with chest pain, shortness of breath, back pain, numbness or weakness, trouble speaking, or vision changes. If you have a reading that high without symptoms, rest five minutes, recheck, and call your clinician the same day.

Want more support?

Our High Blood Pressure Take Control Care Kit includes a tracking log, wallet card, low-sodium food guide and a doctor question sheet: Get the kit.

Prefer to learn with others? Join our monthly membership for live Saturday sessions at 10:00 AM, where each month we take on one topic together: Join Suilen Health.

Sources

American Heart Association / American College of Cardiology. 2025 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults.
American Heart Association and American Stroke Association. Heart Disease and Stroke Statistics (prevalence of hypertension in Black adults).
JAMA Cardiology. Age at hypertension diagnosis in Black and white adults.
Journal of the American Heart Association, 2018. CARDIA study, cumulative incidence of hypertension in Black adults.
Hypertension, 2021. Hypertension and excess stroke risk in Black adults.