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Non-Hispanic Blacks (NHB) have a greater prevalence cardiovascular disease (CVD) and CVD risk factors, and they appear at an earlier age compared with non-Hispanic Whites. Impaired vascular function is a major contributing factor to CVD risk, and NHB have impaired vascular function compared with non-Hispanic Whites. In addition to the known biological factors, socioeconomic and environmental determinants of CVD are particularly important for NHB. Chronic exposure to racial discrimination (racialized stress) throughout the lifespan represents an allostatic load whereby the stress-response mechanism is activated repeatedly. This activates the central nervous system and other physiological systems that can cause CVD. High allostatic scores are associated with being NHB or Hispanic. The purpose of this review article is to describe the racial health disparities in the CVDs, the social determinants of CVD disparities, and how racial discrimination impacts them.