During the final decades of the 20th century, major medical advances in the prevention and treatment of cardiovascular diseases contributed to declining rates of death from cardiovascular disease.1,2 Despite these recent reductions in overall cardiovascular death rates in the United States, the overall incidence of acute myocardial infarction (MI) has not declined and has actually increased among women.2 Cardiovascular disease remains the leading cause of death worldwide and is a major cause of disability. The epidemic of obesity and associated diabetes is expected to further increase the prevalence of cardiovascular disease in the 21st century.3,4
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