It has been shown that, among white males and females, recent declines in mortality from coronary heart disease (CHD) have not been uniform by region or state. Some clustering has emerged. To describe trends for the black population by states, we compared CHD death rates for persons aged 35 to 74 years for the years 1968-1972 in combination with rates for 1978. Reported mortality from 34 states with reasonably large black populations was described. Not all of the recent geographic shifts for white CHD mortality rates were apparent for blacks. Yet there were similarities, chief of which were the slower decline, and therefore worsening, of relative CHD mortality in certain states in Appalachia.