Skin color has long been known to be an indicator of an individual's risk of developing various diseases, including cardiovascular disease. The link between skin color and coronary artery disease (CAD) is particularly strong, with darker-skinned individuals being at a higher risk of developing this condition than those with lighter skin. The exact mechanisms by which skin color affects CAD risk are not fully understood, but several factors are thought to play a role. One of the most significant is the presence of melanin in the skin. Melanin is a pigment that gives color to the skin, hair, and eyes, and it is also a powerful antioxidant. It is believed that the presence of melanin in the skin may protect against the damage caused by UV radiation and other environmental toxins, which in turn helps to reduce the risk of CAD. Another factor that is thought to contribute to the link between skin color and CAD is the production of vitamin D. Vitamin D is an essential nutrient that plays a critical role in maintaining healthy bones and teeth, as well as in regulating the immune system. It is produced in the skin when it is exposed to sunlight, and darker-skinned individuals typically require more sun exposure to produce the same amount of vitamin D as lighter-skinned individuals. This increased sun exposure can lead to a higher risk of skin cancer, but it may also help to protect against CAD by reducing inflammation and improving the health of the blood vessels. Other potential risk factors for CAD that may be related to skin color include high blood pressure, diabetes, and obesity. These conditions are more common in darker-skinned individuals, and they are known to contribute to the development of CAD. Additionally, genetic factors may also play a role in the link between skin color and CAD, as certain genetic variations have been associated with an increased risk of this condition. Overall, while the link between skin color and CAD is complex and not fully understood, it is clear that darker-skinned individuals are at a higher risk of developing this condition. To reduce their risk, individuals with darker skin should focus on maintaining a healthy lifestyle, including eating a balanced diet, getting regular exercise, and avoiding smoking and excessive alcohol consumption. They should also be sure to get enough sunlight exposure to produce enough vitamin D, but also protect themselves from sun damage by using sunblock, wearing protective clothing and limiting sun exposure during peak hours. In conclusion, skin color is a complex trait, and the mechanisms by which it affects CAD risk are not fully understood. However, darker-skinned individuals are known to be at a higher risk of developing CAD, and it is important for them to focus on maintaining a healthy lifestyle, including getting enough vitamin D, to reduce their risk. Dr. A. Arrazaghi. MD,FRCPC