Lifestyle Incongruity has been shown to be associated with elevated blood pressure in various developing societies. We sought to test this model in an international collaborative study of hypertension in populations of African origin. Data were available for 4770 men and women, aged 25-74, from Africa, the Caribbean, and the United States. The main effects of lifestyle score (LSS) and education on hypertension prevalence were explored, as well as interactions predicted by the Lifestyle Incongruity model. Significant interactions were observed, but only the U.S. men conformed to the pattern predicted. For this group, adjusted ORs for LSS were 4.45 among low-education and 0.71 among high-education subgroups (risk OR = 0.16, 0.03-0.84 95% CI). The Lifestyle Incongruity model therefore received limited support. The model was designed to describe processes in societies experiencing modernization and opportunities for lifestyle differentiation, conditions that may not have been met in some sites.