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...connected his lifestyle to his heart.

"Six months before the heart attack, my doctor told me I had borderline high cholesterol and high blood pressure," says Andre, of Rockville, Md. "But I didn't think much of it."

That all changed after he experienced heart attack symptoms--extreme fatigue, dizziness, and back pain. Tests revealed that Andre had three clogged coronary arteries. "Now I walk every day at lunch, eat smaller portions, and I'm a food label reader," he says.

Bonnie Brown, 50, of Baltimore, says she also didn't change her life until she had a heart attack in 1997. "I used to smoke, ate cold-cut subs for breakfast, and had lots of fried foods, all the time, any time," Brown says. But her heart attack-which she initially mistook for a bad case of indigestion--led her to give up cigarettes, improve her diet, and sign up for weekly water aerobics and line dancing classes.

"There's nothing that motivates people like having a heart attack or bypass surgery," says Christopher Cates, M.D., director of vascular intervention at the Emory Heart Center in Atlanta. "I've found that people think that heart disease always happens to someone else, until it happens to them." Experts say that until Americans change their way of thinking from one of damage control to one of proactive prevention, heart disease will remain the No.1 killer of men and women in the United States.

"In many ways, I think we've become insulated by high-tech care," Cates says. "As physicians, we are partners in the health care of our patients, which means we need to educate them about their risk factors for heart disease. And they need to have some sense of ownership about what they can control. They can't simply look to their doctors or to the FDA or to Medicine, and say, 'Cure me, but I'm going to eat fatty foods, smoke, and be sedentary.'"

One of the reasons that some people may shrug off the possibility of developing heart disease is that it's a gradual, lifelong process that people can't see or feel. About the size of a fist, the heart muscle relies on oxygen and nutrients to continually pump blood through the circulatory system. In coronary artery disease, the most common type of heart disease, plaque builds up in the coronary arteries, the vessels that bring oxygen and nutrients to the heart muscle. As the walls of the arteries get clogged, the space through which blood flows narrows. This decreases or cuts off the supply of oxygen and nutrients, which can result in chest pain or a heart attack. Damage can result when the supply is cut off for more than a few minutes. It's called a heart attack when prolonged chest pain or symptoms (20 minutes or more) are associated with permanent damage to the heart muscle.

Every year, more than 1 million people have heart attacks, according to the National Heart, Lung, and Blood Institute (NHLBI). About 13 million Americans have coronary heart disease, and about half a million people die from it each year.

What's Your Risk Profile?

Risk factors for heart disease are typically labeled "uncontrollable" or "controllable." The main uncontrollable risk factors are age, gender, and a family history of heart disease, especially at an early age.

The risk of heart disease rises as people age, and men tend to develop it earlier. Specifically, men ages 45 and older are at increased risk of heart disease, while women 55 and older are at increased risk. A woman's natural hormones give some level of protection from heart disease before menopause

"Heart disease presents in women an average of...

NOTE: All illustrations and photos have been removed from this article.



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