Racial differences in cardiac structure and function were evaluated in 62 black and 71 white healthy young adults. Left ventricular (LV) mass index, relative wall thickness, fractional shortening, resting cardiac index and resting systemic vascular resistance index were estimated using M-mode echocardiography. Pulsed Doppler interrogation of transmitral flow was used to characterize LV filling. Average daytime blood pressure (BP) was determined by ambulatory monitoring during a typical work or school day. Ambulatory daytime BP averaged 127 +/- 12/80 +/- 7 mm Hg in black subjects, and 127 +/- 9/80 +/- 6 mm Hg in white subjects (p = not significant). The 2 groups were also similar in resting BP, age and gender composition. Relative wall thickness was significantly greater in black than in white subjects (0.37 +/- 0.06 vs 0.34 +/- 0.05; p less than 0.01). This difference was found in both men and women. Black subjects also had a higher resting systemic vascular resistance index (2,110 +/- 570 vs 1,920 +/- 500 dynes.s.cm-5.m2; p less than 0.05) and lower resting cardiac index (3.14 +/- 0.84 vs 3.46 +/- 0.85 L/min/m2; p less than 0.05). There were no significant differences between black and white subjects in LV mass index, fractional shortening and normalized peak filling velocity. These results suggest that racial differences in LV structure and systemic hemodynamics exist even in patients without sustained hypertension. In our study population, the greater relative wall thickness in black subjects was not accompanied by significant differences in LV systolic function or diastolic filling.