The single greatest risk factor for most diseases is simply being old. You can be a chain smoking, heavy drinking, overweight, terrible eating, never exercising, 30 something and you almost certainly not have a heart attack. And there are a variety of different reasons for this. Some of them are biological. There are changes that happen in our biology with age. But over the years and decades, slowly, some combination of accumulated time, so these things are built up and build up.

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