Racial/ethnic minorities in the United States have a risk for coronary artery disease (CAD) that is at least equivalent to that in the white majority. African Americans have greater cardiovascular mortality rates and greater risk for early mortality caused by CAD. Risk may be associated with a greater clustering of risk factors in African Americans and other minority groups and may be associated with inadequate screening and evidence-based treatment of these groups in clinical practice. Data are beginning to emerge showing racial/ethnic variation in levels of the inflammatory marker high-sensitivity C-reactive protein, with higher levels in African Americans than in whites. There remain significant challenges to understanding racial/ethnic differences in cardiovascular risk factors and to including minority groups in clinical trials of therapeutic interventions, thereby ensuring optimal treatment for all.