By Robert Bazell Chief science and health correspondent
NBC News
updated 9/16/2004 3:19:41 PM ET 2004-09-16T19:19:41

David Hunke did not pay attention to his many risk factors for heart disease.

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"I felt pretty good," he says. That is, until his 50th birthday when he had a heart attack.

It's an all-too-common story and cardiologists hope former President Bill Clinton's case will inspire millions to take steps earlier to reduce their risk.

"I am literally thrilled at the potential benefit that this all could have in getting people to take this seriously. It's been an amazing frustration," says Dr. Christopher Cannon of Brigham and Women's Hospital in Boston.

Most confusing to many people is that the president's disease progressed even though he lost weight over the past few years.

Test yourself"It's nice that he lost some weight and that he was trying, but it meant that it wasn't enough to reverse years and years of unhealthful living," says Dr. Pam Douglas of Duke University Medical Center in Durham, N.C.

Clinton also took stress tests and said he "aced" them for four or five years. However, the tests are not foolproof and can miss severe blockage in the arteries.

"A negative stress test does not make you immune from having a heart attack or even from having sudden cardiac death," says Dr. Steve Nissen of the Cleveland Clinic.

In fact, there is no good test for people without symptoms. Doctors are working with CT scans of the heart, but most say they are still unreliable and expose the patient to large doses of radiation. 

Doctors say it is important for people to understand that even though Clinton ended up with severe heart disease, it is never too late to take steps to reduce the risk. The keys to prevention are well-known: Stop smoking, avoid saturated fats, exercise, and lower your blood pressure and bad cholesterol.

The experts say Clinton missed a big chance to prevent the spread of his heart disease and avoid surgery when he stopped taking cholesterol-lowering statins.

"Had he been on a statin medication, with much lower cholesterol levels, that might have prevented his developing these severe blockages," says Cannon.

As for Hunke, he now takes a statin as part of a comprehensive program to prevent the worsening of his symptoms. Doctors wish more people would think about prevention before the disease strikes.

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