Cancer is the overgrowth of cells in the body and tumor suppressor genes such as BRCA1 and BRCA2 to prevent the development and growth of cancerous cells in the body. There are more than 4 million breast cancer survivors in the US today. Comorbidities such as cardiovascular disease, diabetes, obesity, high blood pressure, and arthritis can negatively impact breast cancer survivorship. Women of color are 40% more likely to die from breast cancer than Non-Hispanic White women. Having a comorbidity decreases 5-years relative survival rates and prevents the patient from receiving the full benefits of cancer therapy. The objective of our study is to investigate the risk of cardiovascular disease among rural Non-Hispanic Black (NHB), and Non-Hispanic Whites (NHW) breast cancer survivors compared to their counterparts in the SEER-Medicare data. This study was based on a retrospective population-based cohort of 1,108 rural NHB, 4,702 urban NHB, 23,280 rural NHW and 75,987 urban NHW breast cancer survivors. Other eligibility criteria that were used to identify the cohort in this study were age at cancer diagnosis >65 years, and diagnosis years 2000-2017. Rural NHW breast cancer survivors had a higher proportion without baseline comorbidities (56.7%) compared to rural NHB breast cancer survivors (35.5%). Rural NHB breast cancer patients were less likely to receive surgery and radiation therapy, but more likely to receive chemotherapy than rural NHW breast cancer patients. The risk of cardiovascular disease increased significantly among rural vs. urban patients among NHB breast cancer survivors (HR for heart failure NHW=1.20, 95%CI=1.16, 1.24). Cardiovascular disease prevention may thus be of particular importance for rural NHB breast cancer survivors.