Minding the competition: racial differences in cardiovascular risk.

Although we have made great strides in reducing the burden of cardiovascular disease over the past 50 years, blacks in the United States still face increased cardiovascular mortality, along with a disproportionate burden of risk factors.1–3 However, if race-based comparisons become the basis for action, it is essential that they be measured and interpreted accurately. Blacks experience higher mortality rates of noncardiovascular disease (non-CVD).2 Some have argued that without accounting for non-CVD related deaths among blacks, epidemiologists may be overestimating the true comparative rate of incident cardiovascular events among blacks. In other words, by failing to mind the competition, we may be overestimating the race-based gap in CVD.4,5