Hypertension related diseases are major causes of morbidity and mortality among United States Blacks. Among Blacks and whites, lower levels of education are associated with higher levels of blood pressure, stroke, and coronary heart disease mortality. High levels of blood pressure in United States Blacks compared to United States whites persist even after controlling for education. Furthermore, it has been demonstrated that individuals living in the southeastern part of the United States continue to have higher stroke and coronary heart disease mortality rates than those living in most other areas of the United States. The number of upwardly mobile Blacks, based on education and occupation, has been increasing in the United States yet relatively little is known about the relationships of improvements in socioeconomic status and cardiovascular risk factors, particularly blood pressure. In Africa, for over four decades, hypertension has been regarded as a rare disease among the Black Africans. However, recent evidence from hospital and community based populations suggests that hypertension is the most prevalent cardiovascular disease among Africans and constitutes a major public health problem, particularly in West Africa. Furthermore, stroke is an increasing health problem.