Jackson (2005) raised a number of issues in her response to Armelagos' commentary on the Slavery Hypertension Hypothesis. Armelagos focused on the lack of evidence for a genetic bottleneck that predisposes the descendents of the survivors of the Middle Passage and enslavement to hypertension. He was critical of the acceptance of the Hypothesis without scientific evidence to support it. Armelagos suggested that examining contemporary biocultural processes would be a more profitable approach to understanding hypertension among African Americans. Jackson has argued that genetic admixture and the up-regulation of germ line genetic variability induced by environmental stressors have partly diluted a putative genetic bottleneck associated with selection pressures during the Middle Passage and enslavement. Specifically, we suggest that stress-induced physiological changes during gestation can affect kidney development leading to hypertension, and that psychosocial factors suggested by Dressler and coworkers contribute to hypertension as a health disparity.