In this episode of Behind the Science, Adith Arun sits down with Rishi Shah to uncover the surprising realities behind new JACC data reports on U.S. cardiovascular health. They break down why major gaps in exercise, sleep, medication adherence, and access still persist—despite gains in insurance coverage. Using NHIS data from 2019–2024, Adith and Rishi explore the stubborn income driven disparities shaping ASCVD risk and discuss what it will take to finally improve cardiovascular equity. A must watch for anyone focused on heart health, population data, or the future of cardiology.