A family history of heart disease is generally defined by having a first-degree male relative (i.e., father or brother) who had a heart attack by age 55, or a first-degree female relative (i.e., mother or sister) by age 65. Just as important, consider lifestyle changes that improve your heart health. Cardiovascular disease (CVD) is a class of diseases that affect the heart or blood vessels.  Cardiovascular disease includes coronary artery disease (CAD) such as angina and myocardial infarction (called heart attack). Other cardiovascular diseases include stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, abnormal heart rhythms, congenital heart disease, peripheral arterial cardiac disease, thromboembolic disease and venous thrombosis. The underlying mechanisms vary depending on the disease.  Coronary artery disease, stroke, and peripheral arterial disease involve atherosclerosis. This can be caused by high blood pressure, smoking, diabetes mellitus, lack of exercise, obesity, high cholesterol, poor diet, and excessive alcohol consumption among others. It is estimated that high blood pressure accounts for approximately 13% of CVD deaths, while tobacco accounts for 9%, diabetes 6%, lack of exercise 6% and obesity 5%. Untreated strep throat after rheumatic heart disease can occur.  There is evidence that cardiovascular disease existed in prehistoric times and research on cardiovascular disease dates back to at least the 18th century. The causes, prevention, and / or treatment of all forms of cardiovascular disease remain active in biomedical research.