Despite enormous strides in our understanding of the potential risk factors implicated in cardiovascular disease (CVD), there has been a marked underrepresentation of data among ethnic minority groups in the published studies to date. It is critically important that this imbalance is addressed because it is clear that there are considerable variations in the rate of cardiovascular events and mortality among the differing ethnic groups, at least in the United Kingdom. See page 2362 Compared with Caucasians, Afro-Caribbeans and people of African descent have an elevated risk (&1.5 to 2.5 times greater) of hypertension and diabetes mellitus, as well as related complications such as stroke, insulin resistance, and end-stage renal failure.1–6 Yet paradoxically, they have a far lower incidence of coronary artery disease than both south Asians (originating in the Indian subcontinent) and white Caucasians. The reasons for this apparent disparity are not clear but may relate to the clustering of known cardiovascular risk factors among the different ethnic groups. For example, when compared with Caucasians, Afro-Caribbeans are noted (in some studies) to have an increased incidence of obesity as well as lower levels of low-density lipoprotein cholesterol (yet higher high-density lipoprotein cholesterol) and of smoking rates and abnormal levels of adhesion molecules (which are implicated in coronary atheromatous plaque formation), such as vascular cell adhesion molecule-1, intracellular adhesion molecule-1, and soluble P-selectin.2,3,5,7–11 In the Table we present an overview of some of the key studies that have compared the known cardiovascular risk factors and CVD among the two groups. View this table: TABLE 1. A Summary of Key Articles Comparing Cardiovascular Risk Factors Among Afro-Caribbeans Compared With Caucasians Atherosclerosis …