Top causes of death, US MenWomenHeart diseaseCancerStroke Accidents (50% automobile)COPD COPDPneumonia PneumoniaDiabetes (Types II) Diabetes (Type II)Accidents (40% automobile) SuicideAlzheimer’s disease Chronic liver diseaseKidney disease HomicideSepticemia Young men (15-24)Young women (15-24) Accidents (60% automobile)Accidents (85% automobile)Homicide SuicideCancer

Top causes of deathContributing factors Heart diseaseDiet, smoking, exercise, stress (BP, immune fx) CancerGenes, environmental exposures (smoking) StrokeDiet, smoking, exercise, stress (BP) Accidents (mostly automobile)Speeding, recklessness, seatbelt use COPDSmoking, other environmental exposures PneumoniaVaccination, stress (immune fx) Diabetes (Type II)Genes, diet, exercise, stress (immune fx) SuicideDepression, recklessness Alzheimer’s disease? Diet, stress (immune fx) Chronic liver diseaseAlcohol and drug use Kidney disease(see Type II diabetes) HomicideHostility, recklessness SepticemiaStress (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 easily aroused hostility sense of time urgency intolerant of “slow” behavior competitive achievement strivings work more, multi-task often dissatisfied with output Type C Personality 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