The development of CHD in African American women occurs as a result of a complex interplay between risk factors socioeconomic status, access to health care and behavioral and coping mechanisms. It has been well documented that measures of socioeconomic status such as income, education, and occupation are inversely related to CHD and its risk factors including; hypertension, smoking, high blood cholesterol, physical inactivity ,obesity and diabetes mellitus (Those risk factors that are the most worrisome in African American women) (23). Differences in access to cardiovascular care as well as psychosocial and economic factors may be as responsible for disparities in health outcomes between black and white women as any genetic or biological mechanisms.