According to the American Heart Association, African Americans in the U.S. have a higher prevalence of high blood pressure than any other racial and ethnic group. 40% of African Americans in the U.S have hypertension.

On average, hypertension affects this group at an earlier stage in life and is more severe in comparison to other ethnic groups (1). If left uncontrolled, high blood pressure can damage blood vessels in various parts of the body such as the heart, brain, and kidneys. Unfortunately, individuals with hypertension can be entirely asymptomatic and experience consequences without ever knowing.  

Genetic makeup may increase risk of hypertension, but diet also plays a role. When too much sodium is consumed, the body holds onto extra water, putting strain on the heart and blood vessels, resulting in elevated blood pressure.

The most recent Dietary Guidelines for Americans indicates that 90% of Americans exceed the Chronic Disease Risk Reduction sodium limit of 2,300 mg/day for those without and 1,500 mg/day for those with high blood pressure (2). Without properly reading nutrition labels and/or having established methods to control sodium intake, it is easy to unconsciously exceed the daily recommended amount of sodium and increase hypertension risk.  

Some practical ways to decrease overall sodium intake include limiting frozen, processed, & high sodium foods (i.e., frozen dinners, pizza, fast food, salted snacks, canned foods, & deli/dried meats), cooking with more herbs/spices instead of salt, and avoiding the addition of salt to already-prepared dishes.  

There is a nutrient that can help too; research suggests that black individuals consume less potassium than white individuals. In fact, when black individuals consume potassium-rich foods, salt sensitivity and hypertension risk decrease (5). This is due to potassium’s ability to help manage high blood pressure and rid the body of excess sodium through urine. Potassium also helps ease tension in the vessel walls, which helps further lower blood pressure (3).

High potassium foods come from plant-based sources. Examples include beans, lentils, artichokes, avocados, bananas, brussel sprouts, beets, cantaloupe, potatoes, tomatoes, and cooked spinach (4). For example, 1 cup of cooked spinach contains almost 900 mg of potassium! Potassium recommendations for women aged 18 years and older is 2,600 mg and for men aged 18 years and older is 3,400 mg daily (2). Individuals with kidney disease may need to restrict the amount of potassium, as it can build up to toxic levels in the blood.  

Working with a health team including a dietitian, knowing your risk level, and increasing physical activity are ways to help narrow the racial gap in the prevalence of hypertension. Most research concludes that factors like having good income & insurance make tackling racial disparities in hypertension increasingly challenging. One study concludes that “advancing research efforts in ethnic data collection and culturally-specific treatment strategies are future directions for improving disparities in ethnic minorities” (7).  

 BASE10's Precision Nutrition program is centered around genetic insights, access to a high-touch clinical team, and support from dedicated registered dietitian nutritionists.

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Authors: Greg Lafortune and Stephanie Ineman  

 Resources: 

1. https://www.heart.org/en/health-topics/high-blood-pressure/why-high-blood-pressure-is-a-silent-killer/high-blood-pressure-and-african-americans  
2. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf  
3. https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/how-potassium-can-help-control-high-blood-pressure#:~:text=The%20more%20potassium%20you%20eat,80%20who%20are%20otherwise%20healthy.  
4. https://www.eatright.org/health/diseases-and-conditions/kidney-disease/kidney-disease-high-and-moderate-potassium-foods  
5. https://journals.physiology.org/doi/abs/10.1152/ajpheart.00980.2020?journalCode=ajpheart#:~:text=With%20respect%20to%20cause%20and,racial%20disparities%20in%20salt%20sensitivity.  
6. https://www.nih.gov/news-events/news-releases/nih-scientists-link-genetics-risk-high-blood-pressure-among-blacks  
7. https://www.acc.org/latest-in-cardiology/articles/2020/04/06/08/53/racial-disparities-in-hypertension-prevalence-and-management  
   

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Located in Chicago, BASE10 is a healthcare software technology company whose platform creates turnkey disease management programs that can be deployed at scale for nursing home operators, pharmacies, payors, and self-funded employers.