Prevalence of hypertension is nearly 40% greater in African Americans than in whites and its sequelae are more frequent and severe. Evidence of target organ damage such as renal failure and left ventricular hypertrophy is more common in black than white hypertensives at comparable levels of blood pressure. Many risk factors are also more common in blacks, including diabetes, high serum lipoprotein levels [Lp(a)], and obesity (in women). Other risk factors, such as elevated total cholesterol, reduced high-density lipoprotein (HDL)-cholesterol, and heavy cigarette smoking, are more common in whites.