The ethnic-specific nature of mechanisms for coronary heart disease.

Cardiovascular disease extracts an enormous toll from the life and health of America’s black population. The increased differential effect of cardiovascular disease on African Americans is particularly marked in women (1). Figure 1 shows the annual rate of first heart attack by age in the U.S. for black and white men and women between 1987 and 1994 (2). Recent reductions in cardiovascular morbidity and mortality in the U.S. have been less impressive in black individuals. Gillum (3) reported that the age-adjusted death rates for white men fell faster than the same statistic for black men between 1980 and 1990. Cooper (4) reported that, while a similar deceleration in coronary heart disease incidence existed for blacks and whites before 1979, incidence curves have been diverging since that year so that the ethnic gap in coronary heart disease incidence is widening.