In 1899, W. E. B. Du Bois reported that Black American people were much more likely to die of heart disease than their white counterparts in his landmark sociological study The Philadelphia Negro. Since then, Black individuals in the USA and UK have continued to experience higher rates of hypertension, coronary artery disease and stroke than white individuals. Although socioeconomic status and access to health care have important roles in these cardiovascular disparities, these factors cannot fully explain the differences in health outcomes between Black and white individuals. Stress and racial discrimination have been postulated to be important drivers of cardiovascular inequalities; however, their specific role in cardiovascular disparities remained unclear.

In 1985–1986, nearly a hundred years after Du Bois’ seminal study, the CARDIA study was launched to investigate the development of cardiovascular disease risk factors in a diverse cohort of young Black and white adults in the USA. Over 35 years, longitudinal data from CARDIA have provided crucial insights into the life course of cardiovascular health and ageing, cardiovascular disease, and racial and sex-related differences.