In JAMA, a new meta-analysis studied 400,000 people for up to 30 years. It shows that diet and lifestyle habits—not genes and not fate—cause heart attacks…the Vioxx effect notwithstanding.

A second meta-analysis of 122,000 more people many of whom were having heart attacks, showed the same thing: cigarette smoking, diabetes, hyperlipidemia, and hypertension–are responsible.

Greenland at Northwestern in Chicago writes, “Unfavorable levels of blood cholesterol and blood pressure, cigarette smoking, overweight/obesity, and diabetes are well established as the major causal factors for CHD.” Dr. Khot at the Cleveland Clinic concurs: they are “largely preventable by a healthy lifestyle.”

What can you do about it? Everything. Small changes make a big difference in your risk for heart disease and for aging.