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Top causes of death, US Men Heart disease Cancer Stroke Accidents (50% automobile) COPD Pneumonia Diabetes (Type II) Suicide Chronic liver disease Homicide Women Heart disease Cancer Stroke COPD Pneumonia Diabetes (Types II) Accidents (40% automobile) Alzheimer’s disease Kidney disease Septicemia Young men (15-24) Accidents (60% automobile) Homicide Suicide Young women (15-24) Accidents (85% automobile) Homicide Cancer Top causes of death Contributing factors Heart disease Diet, smoking, exercise, stress (BP, immune fx) Cancer Genes, environmental exposures (smoking) Stroke Diet, smoking, exercise, stress (BP) Accidents (mostly automobile) Speeding, recklessness, seatbelt use COPD Smoking, other environmental exposures Pneumonia Vaccination, stress (immune fx) Diabetes (Type II) Genes, diet, exercise, stress (immune fx) Suicide Depression, recklessness Alzheimer’s disease ? Diet, stress (immune fx) Chronic liver disease Alcohol and drug use Kidney disease (see Type II diabetes) Homicide Hostility, recklessness Septicemia Stress (immune fx) Fatty streaks: concentration of LDL cholesterol in the vessel walls that can . . . progress to . . . Raised lesions: formation of fibrin cap over lesion including LDL cholesterol and inflammation – aka atherosclerosis, a major cause of heart attack and stroke Other risk factors in young adults: hypertension, obesity, poor glucose tolerance McGill et al., Am J of Clinical Nutrition, 2000 Friedman et al., J Personality Social Psychology, 1993 Type A Personality Type C Personality easily aroused hostility sense of time urgency intolerant of “slow” behavior competitive achievement strivings work more, multi-task often dissatisfied with output passive acquiescent emotionally repressed inhibited when stressed, depressed and hopeless “cynical hostility” increases blood pressure, risk of heart disease depression dysregulates immune function, increases risk for cancer depression increases risk of heart disease hostility dysregulates immune function, increases risk for cancer