Cardiovascular risk reduction among African Americans: a call to action.

African Americans are at greater risk for cardiovascular morbidity and mortality than European Americans or Asians. They also bear a disproportionately greater burden from type-2 diabetes mellitus. Not as much access to healthcare and less intensive use of available therapies may explain some of these disparities. However, the high prevalence of potentially modifiable risk factors, particularly hypertension and dyslipidemia, in African Americans also provides great opportunity for the prevention and treatment of cardiovascular disease in this population. In addition to lifestyle approaches, achieving aggressive goals for blood pressure (< or =130/80 mmHg) and low-density-lipoprotein cholesterol (<100 mg/dL, or <70 mg/dL for patients at very high cardiovascular risk, including those with diabetes) will necessitate the use of effective pharmacologic therapies. Clinical trial data indicate that antihypertensive regimens, particularly those that include a diuretic, are as effective in African Americans as in other racial/ethnic groups. Moreover, potent statins have been shown to decrease low-density-lipoprotein cholesterol to goal levels in African-American patients.