Hypertension (HTN) is a highly prevalent risk factor for cardiovascular (CV), cerebrovascular, and renal diseases and disproportionately affects African Americans (AAs). It has been shown that promoting the adoption of healthy lifestyles, ones that involve best practices of diet and exercise and abundant expert support, can, in a healthcare setting, reduce the incidence of hypertension in those who are at high risk. In this paper, we will examine whether similar programs are effective in the AA church-community-based participatory research settings, outside of the healthcare arena. If successful, these church-based approaches may be applied successfully to reduce the incidence and consequences of hypertension in large communities with potentially huge impact on public health. 1. Introduction Hypertension (HTN) is one of the most common diseases facing the American public today with elevated blood pressure (BP) representing the number 1 attributable risk for death worldwide [1–3]. The National Health and Nutrition Examination Survey (NHANES) data indicate that the age-standardized prevalence of HTN increased from 24.4% to 28.9% ( ) between surveys conducted in 1989–1991 and 1999–2004 [4]. An aging population, growing rates of obesity, high-sodium diets, and a sedentary lifestyle all are thought to contribute to this increase [5]. Nationally, HTN is the largest treatable contributor to stroke and the second largest contributor to coronary artery disease (CAD). It is also the second leading cause of end-stage renal disease and contributes significantly to congestive heart failure [6]. HTN increases the risk of stroke, heart attack, heart failure, and kidney disease [1, 3], and though it is a modifiable risk factor for all the aforementioned diseases, however, no significant change in HTN prevalence is seen from 1999 to 2006 [7, 8]. In 2005-2006, approximately 29% of the US population over the age of 18 was hypertensive (almost equal prevalence between male and female), with the definition of HTN being systolic BP (SBP) ≥140？mm？Hg and/or diastolic BP (DBP) ≥90？mm？Hg, or taking medications for HTN [3, 7, 8]. The prevalence of HTN increased with age from 7% among those aged 18–39 years to 67% among those aged 60 years and older [7]. Furthermore, during this time period, pre-HTN, defined as SBP between 120–139？mm？Hg and DBP between 80–89？mm？Hg emerged as is an independent risk factor for cardiovascular disease (CVD) [9] and is associated with an increase in all-cause and CV mortality [10–14]. Currently an estimated 37% of adult Americans have pre-HTN,
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