Cardiovascular disease in African Americans is often driven by high blood pressure. Learn the risk factors and how Norton Heart & Vascular Institute can help.

Author: Sara O. Thompson

Medically reviewed by:
Bassel Alkhalil, MD

Published: February 22, 2019 | Updated: October 6, 2026

Estimated reading time: 3 minutes

Heart disease kills more Americans than any other illness, and African Americans may face a higher risk for heart disease. A leading cause of heart disease for all people is uncontrolled high blood pressure, and African Americans have the highest rate of high blood pressure compared with other groups, according to the American Heart Association.

The role of high blood pressure in heart disease and heart failure

“Nonischemic heart failure” is heart failure that is not caused by blockages. Instead, high blood pressure often is the cause. Many theories exist on why African American people have a higher rate of cardiovascular disease. The most likely answer is underlying high blood pressure. Researchers think the typical African American diet, which can be high in fat and salt, may contribute to high blood pressure. High blood pressure can then lead to heart disease, heart failure, heart attack and stroke.  

Other factors that contribute to high blood pressure in African Americans

Some other considerations for African Americans that lead to increased risk:

• African Americans may have subclinical hypertension, which means their high blood pressure has gone unnoticed long enough to affect their heart health.
• High blood pressure is occurring in younger patients, but younger patients may be reluctant to take medication for blood pressure or make lifestyle changes, especially since they don’t have symptoms or feel bad.
• High blood pressure may be recognized or diagnosed later in African Americans who have limited access to healthcare or low awareness of the risk.

Awareness is key

High blood pressure often is called the “silent killer” because it usually has no symptoms. Many people feel healthy while uncontrolled high blood pressure is damaging the heart and blood vessels. Regular blood pressure screenings and ongoing care are important for early detection and treatment.

Early screening and education are essential to reducing the impact of high blood pressure. Community-based blood pressure screenings at churches, barbershops, neighborhood events and other trusted gathering places can help make preventive care more accessible.

Black Americans and heart failure treatment

There is good news for African Americans with heart failure. In addition to the work toward reducing heart disease and heart failure risks in the African American community, heart failure treatment can help.

The late Dr. Kelly McCants, was passionate about prevention, and screening of African Americans for cardiovascular disease. He engaged with the community to encourage awareness and advocated for health equity in both treatment and research to improve health outcomes. Dr. McCants founded the Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program to fulfill this mission.

Specialists at Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program work with patients who have heart failure that is caused by high blood pressure. In some cases, the condition can be reversed, or the heart can recover after heart failure.

Heart failure patients can be referred to the program by their primary care provider or after being admitted to the hospital for heart failure. Our team also can diagnose heart failure in patients who are experiencing symptoms such as lower-extremity swelling, shortness of breath and fatigue.