This study examines self-reported hypertension and its correlates in a random sample of 5539 African-American and white middle-aged women residing in Massachusetts. African-American women reported hypertension more frequently than did whites (38.2% vs 19.8%). African-American women were more likely than white women to have seen a doctor in the preceding year and to have had a hysterectomy. The African-American women were less likely to be current smokers and were less educated than white women. Stepwise logistic regression revealed that self-reported hypertension was associated with race, education, health care utilization, and the interaction of education and race. Prevalence differences between African Americans and whites declined with increasing education. However, the model indicates that after controlling for differences in socioeconomic status (based on education) and health care utilization, self-reported hypertension was still more prevalent among African-American women.