Objectives. To examine African American patient perceptions of racial discrimination in clinical encounters. General barriers to hypertension management were also investigated. Methods. Six focus groups with 37 African American hypertensive patients were conducted and the transcribed sessions were analyzed for content. Results. Patients valued providers who shared information regarding self-care behaviors to manage hypertension and those who provided information regarding treatment options. Provider assumptions about patient inability to afford services, and provider apathy in reaching diagnoses were perceived as racially discriminatory. Patients discussed providers' avoidance of touch during physical exams as overtly discriminatory. Patients reacted to discriminatory experiences by not keeping appointments with providers perceived as racially discriminatory. Barriers to hypertension management were associated with family responsibilities and lifestyle factors, but were not attributed to provider racial biases. Conclusion. Perceiving racial discrimination in clinical encounters may be an important barrier to appointment attendance for African American hypertensive patients.