Black Americans suffer disproportionate incidences of severe complications associated with hypertension and cardiovascular disease. Psychosocial factors and subsequent coping responses have been implicated in the etiology of disease. Perceived racism has been identified as a source of stress for Blacks and is related to anger, hostility, paranoia, and greater blood pressure reactivity. The impact of coping responses to perceived racism on blood pressure levels in 52 Black adults was examined in this study. Twenty-four hour ambulatory blood pressure, self-reported perceived racism, and coping responses to racism measures were assessed. Regression analyses indicated that (a) passive coping (i.e., avoidance) predicted higher blood pressure levels and (b) active coping (i.e., trying to change things) predicted lower blood pressure levels. Additionally, blood pressure levels were significantly higher in those reporting greater exposure to racism. (Contains 9 tables.)