Stress, stress reduction, and hypertension in African Americans: an updated review

J Natl Med Assoc. 1997 Jul;89(7):464-76.


This is a comprehensive and integrative review of multiple factors underlying the greater prevalence of hypertension in African Americans compared with whites. Evidence linking stress with hypertension and cardiovascular disease in African Americans is reviewed. A survey of mechanisms of hypertension in African Americans and existing behavioral strategies for the treatment of hypertension is presented. Given that the excess of hypertension may be mediated in part by behavioral factors operating through biological mechanisms, a case is presented for behavioral stress reduction measures. This review of stress reduction techniques especially the Transcendental Mediation program for the treatment of hypertension in African Americans highlights current issues facing the field. New information is provided to help direct future nonpharmacological research and practice in hypertension to prevent morbidity and premature mortality in this underserved population.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Behavior Therapy
  • Black People*
  • Black or African American
  • Female
  • Heart Diseases / etiology
  • Humans
  • Hypertension / etiology*
  • Hypertension / physiopathology
  • Hypertension / prevention & control
  • Hypertension / psychology
  • Male
  • Meditation
  • Prevalence
  • Stress, Physiological / complications*
  • Stress, Physiological / prevention & control
  • Stress, Psychological / complications*
  • Stress, Psychological / prevention & control
  • White People


  • Antihypertensive Agents