Despite the great strides made by cardiology, cardiovascular disease still causes 7 million deaths a year around the world, and is the number one cause of death in developed countries. There are 150,000 new cases in Greece every year, 75 percent of which stem from known risk factors (high cholesterol, high blood pressure and obesity), caused by smoking, improper diet and lack of physical activity. These cases «are not inevitable» Professor Pavlos Toutouzas, director of the Greek Cardiology Foundation, told Kathimerini. A study by the University Cardiology Clinic at the Hippocrateio Hospital reveals the significant role played in heart disease by psychological factors and depression, which doubles the risk rate for women, while men who are divorced or widowed are at even greater risk. Higher levels of education are associated with less smoking, greater income, less depression and better access to information. The Greek Cardiology Foundation is centering its efforts on information, Toutouzas says, since a 2 percent reduction in blood pressure is enough to prevent 1.2 million deaths from strokes and 600,000 deaths from vascular disease. This is why there are now strict recommendations for a healthy heart: Blood pressure must be below 14, sugar levels below 110, total cholesterol below 200, and «good» cholesterol below 50 mg for women and 40 mg for men. The results of such advice are not uniform, however. Many patients visit doctors but do not follow the advice they receive, so hypertension is successfully treated in only 15-20 percent of cases. Dramatic changes in lifestyle have not only affected the known risk factors, but also create the conditions for other factors, such as acute stress, work-related stress, depression, and anger, to which the heart is highly vulnerable.