Black women in the United States have a high prevalence of hypertension and suffer the most complications of cardiovascular disease. Black women, though aware of the dangers associated with hypertension, have limited opportunity to access health care and or change their lifestyles. The purpose of this quantitative cross-sectional study was to test if there was a significant difference in hypertension awareness, health care access/use, and lifestyle modifications in Black women prior to and post implementation of The Patient Protection and Affordable Care Act, as compared to women of other races. The behavior modification theory guided this study. Secondary data from the National Health Interview Survey for the years 2009 to 2013 for women ages 20 - 65 were analyzed using logistic regression analysis. According to the study results, there was no association (p values > 0.05) among variables age, education, income, length of employment, and hypertension awareness, health care access/use, and life style modification among Black women in the United States, as compared to women of other races. The findings from this study may allow researchers and policy makers to develop more culturally significant health services for Black women. These findings could create positive social change by targeting programs that promote hypertension awareness leading to effective lifestyle changes in Black women.