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BWHI and The Heart Truth®: Empowering Black Women to Manage Stress With Self-Care for Heart Health

What does “self-care” mean to you? A day of pampering that, as nice as it sounds, you do not have time for? Or maybe it’s devoting a lot of energy to getting in shape or doing yoga?

The National Heart, Lung, and Blood Institute’s (NHLBI) The Heart Truth® program wants you to know that self-care can mean doing something as simple—and vital—as taking a few minutes daily to de-stress. That helps you manage your blood pressure and protects your heart.[1] Heart disease is largely preventable, and small acts of self-care can go a long way to keep your heart healthy.

“Black women are experiencing unimaginable stress that makes it even more vital for us to do what we need to do for our heart health,” said Zsanai Epps, the Director of My Sister’s Keeper and Positive Period at Black Women’s Health Imperative (BWHI). “We face acute and chronic stress from racism, COVID-19, unequal pay, unemployment, school, and parenting. Learning how to deal with stress and cope with problems will help our overall emotional and physical health.”[2]

How stress undermines your mind and body

Stress, when repeated, can have lasting effects. Your body’s fight or flight response and stress hormones may fail to turn off properly.[3] Over time, that chronic stress can increase your blood pressure and contribute to other heart disease risk factors.[4] It can also cause anxiety, digestive problems, weight gain, and sleeping difficulties. It may also trigger unhealthy behaviors.[5] [6]

“Who we are as Black women matters in the trilogy of our mind, body, and heart. Black women continue to bear the brunt of the psychological stressors that are brought about through our many roles in society, and we need to change that,” said Epps. “As a result, we are also facing huge health problems that we need to address.”

Symptoms of acute or sudden stress can mirror symptoms of a heart attack, such as fatigue, cold sweats, and back pain. Black women may attribute some of the physical symptoms of a heart attack to stress and fail to get help. Don’t delay—call 9-1-1.

“The NHLBI is committed to supporting the inclusive research and outreach to help ensure that Black women get the services, support, and attention they deserve and need,” says NHLBI’s Gina S. Wei, MD, MPH, Senior Scientific Advisor on Women’s Health and Associate Director for Prevention and Population Sciences at the Division of Cardiovascular Sciences. “Through our collaborations with community partners and community health workers, and our commitment in research programs such as the Jackson Heart Study, we want to ensure that Black women’s heart health is never ignored.”

MSK Heart BlogThe numbers tell a motivating story

The Jackson Heart Study found that Black adults with higher stress levels were more likely to have overall poor cardiovascular health. As the numbers below show, young and middle-aged Black women are facing a greater risk from heart disease than white women do. The Women’s Health Initiative Observational Study found that “high stressful life events and social strain were each associated with higher coronary heart disease risk,” the authors concluded. “Job strain and social strain work synergistically to increase coronary heart disease risk.”[7]

Heart disease is the leading cause of death in the United States. However, the research shows:

  • Black women are more likely to die of heart disease, and at younger ages, than white women.[8]
  • The death rate from heart disease for Black women ages 25–44 years is more than twice as high as for white women in that age group, research shows.[9]
  • Almost 90% of Black women ages 40–60 have obesity or overweight, and 73% have high blood pressure.[10]
  • Only about 1 in 4 adults with hypertension have their condition under control.[11]
  • Almost 60% of Black women have some form of heart disease.[12]

Black women and the superwoman syndrome

Self-care is committing to caring for yourself and creating balance in your life. However, this isn’t easy for us to do as Black women because of our roles as matriarchs, decision-makers, and providers in our families. Superwoman syndrome can create barriers for Black women to practice self-care unapologetically. Some of us find it hard to say “No” to things that add to our responsibilities. We are used to being and doing so much for others that we feel guilty taking time for ourselves.

With so many responsibilities and our high expectations, we may feel we can’t take time for ourselves. Yes, we are expected to be good parents or caregivers or employees. However, that doesn’t mean that we don’t deserve time off.

Deciding what self-care looks like for you can be a task within itself. You may not be aware of your own needs because you may not have thought about them or had the time to. Just thinking about your needs can be overwhelming.

Also, when some Black women don’t feel they have the support to take off the superwoman cape, practicing self-care may seem like a sign of weakness.

But one important self-care move is demanding doctors care for your heart health. Providers are less likely to identify and treat cardiac symptoms in Black women, compared to other groups. That makes it more likely we will suffer from cardiovascular disease. [13

Giving stressors a long time out

To get started or to get help continuing your path to less stress, know that you’re never too young or old to care for your heart health. Here are a few tips for de-stressing by triggering your body’s relaxation response.

During the relaxation response, your breathing slows and blood pressure and heart rate decrease. Ways to begin often combine breathing deeply and focusing your attention on pleasing thoughts and images.[14] Relaxation strategies include yoga, progressive muscle relaxation, walking or other physical activity, and mindfulness meditation.[15]  There’s no one way to manage stress.

If you’re short on time, make a list of three-minute activities you love. Add one to each day of your calendar. Consider:

  • Listening to a favorite tune during lunch
  • Stretching after a warm shower
  • Catching a few minutes of the sunrise or sunset.

Finding healthy relaxation exercises is just one way to protect your heart

Combine de-stressing with other heart-healthy habits:

Get more ideas from The Heart Truth’s Stress Less for a Healthier Heart fact sheet.

The BWHI has two signature programs that are helping Black women make positive lifestyle changes, using our culturally tailored curricula as a resource.

  • The My Sister’s Keeper (MSK) heart health program is the BWHI’s group-based, 9-week program using our culturally tailored curriculum Sis, Protect Your Heart. It’s designed for young Black women ages 18 – 30 to protect their hearts both physically and emotionally, to decrease their risk of heart disease.
  • The Change Your Lifestyle. Change Your Life. (CYL2) program is the BWHI’s year-long, evidence-based lifestyle change program that gives participants the tools and support needed to prevent type 2 diabetes and other chronic conditions, such as heart disease, high blood pressure, and high cholesterol. The program is delivered virtually through the new BWHI App, using our curriculum culturally tailored for Black women.

More Black women are recognizing that adopting consistent, personalized, healthful behavior will ultimately help us navigate life’s stressors. It guides us to make choices that support our needs and overall well-being. We’d love to hear what you’re doing—or hope to do—to make self-care and your well-being part of your navigation system.


[3] Lower Stress: How does stress affect the body? | American Heart Association


[5] Lower Stress: How does stress affect the body? | American Heart Association


[7] Wang C, Lê-Scherban F, Taylor J, Salmoirago-Blotcher E, Allison M, Gefen D, Robinson L, Michael YL. Associations of Job Strain, Stressful Life Events, and Social Strain With Coronary Heart Disease in the Women’s Health Initiative Observational Study. J Am Heart Assoc. 2021 Feb;10(5):e017780. .

[8] CDC Wonder 1999 and 2017 US mortality data> 2019 OSPEEC Heart disease stats, p. 9

[9] CDC Wonder 1999 and 2019 US mortality data>2019 OSPEEC Heart disease stats, p. 9-10

[10] NHLBI unpublished tabulation of prevalence estimates from National Health and Nutrition Examination Survey, 2017-2020. From OSPEEC stats released 2022, page 8

[11]> Centers for Disease Control and Prevention. Hypertension Cascade: Hypertension Prevalence, Treatment and Control Estimates Among U.S. Adults Aged 18 Years and Older Applying the Criteria from the American College of Cardiology and American Heart Association’s 2017 Hypertension Guideline—NHANES 2015–2018external icon. Atlanta, GA: U.S. Department of Health and Human Services; 2021. Accessed March 12, 2021.

[12] CDC Wonder 1999 and 2017 US mortality data> OSPEEC Heart disease stats, p. 9  released 2022

[13] Kalinowski J, Taylor JY, Spruill TM. Why Are Young Black Women at High Risk for Cardiovascular Disease? Circulation. 2019 Feb 19;139(8):1003-1004 .>

[14] AHM Stress Less fact sheet

[15] from slide 20 from final version of AHM Jan 2022 webinar

[16] from slide 17 from final version of AHM Jan 2022 webinar