Coronary risk factors were determined in a prospective study of 1,414 elderly persons (999 women and 415 men), mean age 82 +/- 8 years. Of 1,414 persons, 215 (15%) were black and 1,140 (81%) were white. The prevalences of cigarette smoking, hypercholesterolemia, low serum high-density lipoprotein cholesterol, and increased serum total cholesterol/high-density lipoprotein cholesterol ratio were not significantly different in elderly blacks and whites. Elderly blacks had a higher prevalence of hypertension (50% versus 36%, P less than 0.001), diabetes mellitus (27% versus 19%, P less than 0.01), and obesity (11% versus 5%, P less than 0.005) and a lower prevalence of hypertriglyceridemia (9% versus 15%, P less than 0.05) than elderly whites. In elderly persons with hypertension, electrocardiographic left ventricular hypertrophy occurred in 19% of blacks and 14% of whites (P not significant), echocardiographic left ventricular hypertrophy occurred in 72% of blacks and 56% of whites (P less than 0.01), and concentric left ventricular hypertrophy occurred in 60% of blacks and 39% of whites (P less than 0.001).