ARDIOVASCULAR DISEASE (CVD) remains the most common cause of death in industrialized countries, and hypertension is themostfrequenttreatableriskfactor.The analysis of international variation in risk factors has historically resulted in important insights into the etiology of CVD. 1 Moreover,internationalcomparisonsprovide useful information about achievable levels of risk reduction. Most etiologic research studies 1,2 on geographic variation in hypertension have investigated specific hypotheses, such as the role of fat or salt consumption, often choosing extreme social environments to maximize contrasts. Other projects, most notably the World Health Organization Monitoring of Trends and Determinants in Cardiovascular Disease (WHO MONICA) Project, sought to characterize overall coronary risk profiles and monitor trends. 3,4 In recent years, many countries have undertaken large-scale national health surveys that include rigorous measurement of cardiovascular risk status. Considerable epidemiologic research has been conducted using these surveys, such as the US National Health and Nutrition Examination Surveys (NHANES). 5,6 When measurements are Author Affiliations and Financial Disclosure are listed at the end of this article.

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Background: The consistent finding of higher prevalence of hypertension in US blacks compared to whites has led to speculation that African-origin populations are particularly susceptible to this condition. Large surveys now provide new information on this issue.

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