Disparate access to health care makes African Americans especially susceptible to diabetes and associated risk factors. This study analyzes the cost-effectiveness of aggressive treatment of hypertension, hyperglycemia, and hyperlipidemia in an adult population of African Americans and general population with type 2 diabetes. Methods. A Markov model was developed to simulate the progression of cardiovascular disease among a cohort of African Americans and general population with newly diagnosed type 2 diabetes. Data from published studies was used to construct the model. Patients in simulation either received aggressive treatment or treatment as usual. Lifetime costs, incremental costs, incremental quality adjusted life years (QALY) and incremental costs per QALY gained ($/QALY) were assessed. Conclusion. Aggressive treatment was more cost-effective in African Americans than in the general population for all ages under 65 years. The study highlights the economic and health benefits of providing comprehensive diabetes care to all groups, especially African Americans.