In 2006, the United States implemented the Medicare Modernization Act, which expanded prescription drug coverage for Medicare beneficiaries at an estimated cost of $768 billion dollars over the next decade. Improved access to drug benefits may improve cardiovascular outcomes for the elderly by providing financial access to effective therapy. However, there is limited research about the impact of prescription drug coverage on health outcomes. In addition, although black enrollees have been found to have markedly lower use of antihypertensive, lipid-lowering and anti-platelet medications, little is known about the role of prescription drug coverage as a mediator of racial and socioeconomic disparities in cardiovascular outcomes. In this project, we will investigate the effect of prescription drug benefits on the use of appropriate secondary preventive medication and achievement of favorable clinical outcomes among Medicare managed care enrollees with cardiovascular disease. The project will also assess the role of prescription drug coverage in explaining racial and socioeconomic disparities in cardiovascular outcomes.