Drs. Nabel and Braunwald have elegantly illustrated in their Figure 1 that preventive and therapeutic strategies substantially reduced risk for cardiovascular death. In contrast, the death rate from cancer has remained unchanged since 1958. The ratio between cardiovascular death and cancer death has decreased by 45% (from 2.9 to 1.6) over 25 years, and now more and more individuals die of cancer who previously died of cardiovascular disease. The more efficacious cardiovascular drugs are (i.e., the better they protect against cardiovascular death), the more they will increase life expectancy and thus the risk for cancer (pseudocarcinogenicity). Should this pattern continue at the same pace, cancer is prone to strip heart disease of its status as the number 1 killer of Americans. This transition has already happened in Canada, where in 2008 for the first time, cancer was the leading cause of death in every province and territory. The seminal notion of the American Heart Association that “in the past 100 years, only during the 1918 flu pandemic cardiovascular disease was not the number-one cause of death” may rapidly become futile.