Abstract Body: Introduction: Systemic arterial hypertension (SAH) is a multifactorial common public health problem in the elderly Brazilian population. Communities such as the quilombolas, remnants of enslaved peoples, face even more difficulties when compared to urban populations, with evidence in the literature of SAH even in adolescents. Hypothesis: Are there clinical and impeccable differences in hypertension between the quilombola population and urban populations? Method: A total sample of 1127 elderly people (235 quilombolas, 318 São Luís, nearest capital, 574 São Paulo, capital with the highest HDI in the country) were included. Systolic and diastolic blood pressure, ACE gene insertion/deletion polymorphism associated with susceptibility to SAH, BMI, and fasting blood glucose were evaluated and classified in the three populations in the quilombolas and the food consumption of the quilombolas. Results: The classification of hypertension and the distribution of the ACE polymorphism were different between the elderly quilombolas and the two urban populations (which did not differ between them), incidence of hypertension: 81.52% quilombolas, 26.27% São Luís and 27.18% São Paulo) in the ACE polymorphism the elderly quilombolas had a higher incidence of allele I, protective regarding the incidence of hypertension. Regarding BMI, the elderly quilombolas had more underweight individuals and less overweight when compared to the two urban populations. There were no statistical differences in the presence of altered fasting glucose among the 3 populations. Regarding food consumption, the elderly quilombolas had a high consumption of flours and low consumption of vegetables and legumes. Conclusion: It seems that the high incidence of hypertension in elderly quilombolas is more associated with environmental than endogenous factors. We present alarming parameters regarding the incidence of hypertension in the elderly quilombola population, and therefore, public policies need to turn their attention to this vulnerable population.