Discovering the Full Spectrum of Cardiovascular Disease

D espite considerable overall improvement in the clinical prevalence and outcome of cardiovascular disease in the US population during the past 50 years, striking disparities in disease burden plague specific racial/ethnic subgroups.Black patients with cardiovascular disease (CVD) in particular have increased morbidity and mortality as compared with white patients.For example, a black man between 45 and 65 years old is 4 times more likely to have a stroke than his white counterpart.Even when accounting for access to high-quality health care, ethnic minorities bear a higher burden of obesity, type 2 diabetes mellitus, and hypertension as compared with whites.The mechanisms for these disparities remain incompletely understood but likely include a combination of genetic, environmental, and socioeconomic factors.If recent advances in basic science are to be exploited to reduce disparities in cardiovascular health care, then the emerging disciplines in human genetics, biological sciences, and molecular medicine are likely to afford us unprecedented opportunities for deciphering the complex mechanisms involving race/ethnicity, genetic differentiation, allele frequency disparities, and gene-environment interactions.