Racial and ethnic disparities in cardiovascular diseases (CVDs) remain a significant public health challenge, influenced largely by social determinants of health (SDoH). While genetic predispositions play a minor role, inequities in healthcare access, quality, and outcomes are more prominent. This review highlights the impact of race and ethnicity on cardiovascular risk factors, disease prevalence, and management outcomes. Hypertension, diabetes, obesity, coronary artery disease, and valvular heart diseases exhibit pronounced disparities, with minority populations facing higher disease burdens and suboptimal care. In India, the epidemiological shift toward non-communicable diseases has further exacerbated regional disparities. Culturally tailored interventions, equitable healthcare access, and increased representation in clinical research are essential to mitigate these disparities. Addressing SDoH through policy reforms and community-based initiatives can significantly improve cardiovascular health outcomes across racial and ethnic groups.