Hypertension is a preventable and yet major risk factor for early death and morbidity among African Americans. Compared to other women in the US, African American women continue to die earlier and more frequently from preventable and controllable chronic health conditions that are notably due to hypertension and hypertension-related illnesses. While there are multiple factors contributing to the high death rates of African American women, hypertension is one of the most common and modifiable risk factors associated with fatal health outcomes among African American women. The rate of death resulting from hypertension is more than double for African American females compared to white females. Even armed with increased knowledge and awareness, African American women are encountering barriers to controlling their hypertension, which places them at higher risk of becoming sicker and dying earlier than their white counterparts. The purpose of this mixed-methods study was to examine the effects of psychosocial stress on the hypertension self-management behaviors. The rationale for the study is supported by findings from a systematic literature review identifying gaps and contributions in the health literature on African American women and hypertension management. Findings underscore a need to continue to examine psychosocial factors as barriers to African American women’s hypertension self-management. Specifically, the study found statistically significant associations between psychosocial stress and depression as it relates to the hypertension self-management of African American women. Further investigation is warranted to better understand the significance of the relationships between psychosocial stress, depression and African American women’s hypertension self-management.