In this issue of Circulation , Mehta and colleagues1 provide additional information on the state of cardiovascular care for the black population in the United States and, once again, the results remain mixed in our ability to optimize care for all. Their data remain consistent with findings from Bridges et al2 in 2000 in identifying race as an adverse factor for mortality for coronary artery bypass grafting and from Konety et al3 in 2005 who found that the differences in morbidity and mortality outcomes worsened significantly over a 365-day period between blacks and whites in the data set. With advancements in care both medically and operatively for multivessel coronary disease over the past 30 years, there has been a steady improvement in the operative outcomes for all patients undergoing coronary bypass surgery, but there continues to be a persistent disparity in morbidity and mortality between blacks and whites across cardiovascular centers in this country with a direct relationship to these differences based on our definitions of race. Despite a cardiovascular care network that is extensive with modern resources available throughout our systems of care, we are still searching for answers to these differences: solutions that are a mixture of medical and societal ills that we need to understand, accept, and correct. Article see p 124 At 48.9% for women and 44.4% for men, blacks have a significantly higher percentage of both adult men and women who are at risk for coronary artery disease and have overt manifestations of coronary artery disease in comparison with the total population.4 In Mehta’s analysis, the risk factors of hypertension, hyperlipidemia, obesity, diabetes mellitus, and tobacco use are prevalent within the study population. This is not a surprise given the need for the procedure performed; this need is statistically higher for …