Angelina Ng – Department of Health Behavior and Nutrition Sciences, University of Delaware; Alexandra Wynn, PhD – Department of Epidemiology, University of Delaware; Yendelela Cuffee, PhD, MPH – Department of Epidemiology, University of Delaware
Published: March 19, 2026
Hypertension, or high blood pressure, is a cardiovascular disease (CVD) where the force of blood pushing against the arterial walls is too high. Both terms can be used to describe this condition, but hypertension is utilized as a medical term.
Risk factors for high blood pressure include high sodium intake, obesity, physical inactivity, smoking, family history, and genetics. Blood pressure (BP) is described in categories: a normal BP reading is ≤120/80mmHg, elevated BP is 120-129 mmHg/<80mmHg, and hypertension, Stage 1 and 2, start at 130-139/80-89mmHg. Hypertensive emergency and its severe symptoms include chest and back pain, shortness of breath, vision changes, or difficulty speaking.
Health Disparities of Hypertension
Roughly 48% of adults in the U.S. are diagnosed with hypertension. However, only 22.5% with hypertension have their BP under control, while 15.1% had no medical treatment or access to medications . Medication nonadherence is a significant issue, as 31-40% of U.S. adults are nonadherent to their prescribed medication.. This can lead to uncontrolled BP, increased risk of CVD, and mortality in untreated individuals.
Disparities in hypertension prevalence persist, with 58% of African American adults affected, facing up to four times higher CVD mortality than White adults. Systematic factors play a role: lack of access to healthy foods, discrimination in healthcare, and limited access to BP medications.
Data from the Jackson Heart Study indicated that racial discrimination in healthcare can increase African Americans’ risk of developing hypertension by 34-49%. As one of the strongest predictors of CVD, approaches for reducing BP and improving medication adherence must be explored.
Impact of High Blood Pressure on Heart Health
Hypertension impacts cardiovascular health by exerting strain on the heart and arteries, leading to cells rupturing in the inner lining. Hypertension can cause serious heart conditions, including coronary heart disease and heart failure.
The American Heart Association (AHA) developed Life’s Essential 8, which are key measures for improving and maintaining cardiovascular health, including hypertension, through health behaviors and factors. These 8 healthy habits can help patients manage high blood pressure and take control of their heart health.
The four behaviors include eating better, being active, quitting tobacco, and getting healthy sleep. The four factors include managing weight, controlling cholesterol, and managing blood sugar/BP. Implementing Life’s Essential 8 requires structured planning and increased motivation. Goal setting is a key tool that individuals can use to manage hypertension.
Setting Goals for Hypertension Management Goals
SMART Goals is a goal-setting framework that can be useful in managing hypertension. SMART Goals are structured, specific, and easily trackable, which increases the likelihood of success when changing behaviors.
An example of using SMART goals to follow Life’s Essential 8 is as follows:
Specific (define your goal): I will monitor my blood pressure, record readings, and aim to maintain an average blood pressure reading of 120/80mm Hg
Measurable (how your goal will be measured): Blood pressure readings recorded twice a week, 150 minutes of walking
Achievable (how attainable your goal is): Monitoring BP twice a week is attainable. 150 minutes of walking aligns with standard PA recommendations.
Relevant (whether your goal is applicable/appropriate): Goal directly supports hypertension and improves cardiovascular health
Time-bound (deadline of goal): 3-month timeline
Peer Support for Hypertension Management
Peer support involves people with shared experiences coming together to collaborate and offer guidance. This is crucial for hypertension management, as support groups represent a community-driven and accessible way to improve BP management and empower individuals through setbacks.
The University of Alabama found that peer coaching and support significantly improved BP management among young Black adults, even resulting in drops in systolic BP.
An example of goal setting and peer support working together to influence hypertension management can be seen on hbpstories.com, a community sharing site for those with high blood pressure. HBPStories is a behavioral intervention that offers peer support through personal and educational experiences from real-life individuals managing hypertension.
In one example, Angela, an HBP Storyteller, highlights her story about her sedentary lifestyle, from foot pain, ultimately led to a mild heart attack. She speaks about the signs of a heart attack and the actions she took after diagnosis. Angela shares that sodium might be present in foods that some people might not notice.
In addition to providing peer support and raising awareness, stories like Angela’s can encourage others to set goals, which have been shown to reduce systolic BP and improve self-management in adults.
Managing Your High Blood Pressure is Possible
Hypertension has a high prevalence in the U.S., These individuals sat risk for major cardiovascular events, one of the leading causes of death. However, hypertension can be prevented and managed when individuals are supported with proper tools, support systems, and access to healthcare providers. Strategies such as goal setting and peer support can improve blood pressure management and increase motivation to take action against hypertension.
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