A number of factors are known to put people at risk of developing coronary artery disease and having it get progressively worse. Tim Russert displayed some of these risks, and not others.
* Age: Like everyone else, Russert couldn't stop getting older -- he had turned 58 on May 7.
* Gender: "Symptoms can appear in men as early as 35," says Dr. Marianne Legato, professor of clinical medicine at Columbia University in New York City and adjunct professor of medicine at Johns Hopkins University in Baltimore. "And men with this disease are usually dead by the time they're 65." Women are usually not affected until menopause, though protection is lost if they have diabetes.
* Heredity: If an immediate family member has died of heart disease before age 55, a person is at increased risk of developing heart disease. People can't change their genes, but they can let their family's history be a guide to extra watchfulness.
Russert's mother died of cancer and his father ("Big Russ") and three sisters are still living, so his DNA did not signify a heightened heart disease risk. But Legato says Russert's son, Luke, 22, should be examined now to establish a baseline, and he should follow up every two years to make sure he's staying stable.
* High blood pressure, high LDL cholesterol, low HDL cholesterol and diabetes: According to published statements by his internist, Dr. Michael Newman, Russert was taking medication that kept his blood pressure at an acceptable level. But though his overall cholesterol was OK, he had too little "good" HDL cholesterol and unhealthful levels of triglycerides (a type of fat) in the blood. Some news reports have said he had diabetes.
* Large waist size, being overweight or obese: A 40-inch-or-greater waist size (35 inches for women) is a heart disease danger mark, independent of weight -- a mark Russert appeared to have easily surpassed. It signifies the presence of so-called visceral fat, which wraps around the body's internal organs and is linked to heart disease risk. Tom Brokaw, former anchor of "NBC Nightly News," had recently challenged Russert to see who could lose the most weight. Of the two, it was evident that Russert had more to lose -- Newman has called him "significantly overweight" -- but he had already succeeded in dropping about 10 pounds this spring by giving up beer and pizza for Lent (a tradition with him).
