Well, it has been the leading cause of death since 1908 except in 1918 when influenza was number one killer of men and women in this country. And part of is that it is a disease that over the years of risk factors had been cause to it to stay as the number one cause of death but also is that the awareness has not been there. Women do not go to doctors. They do not know they have the disease when they go to their physicians, the study showed that only third of physicians ask their patients whether they are at risk for heart disease or not and because women are always being the caretaker of the family, by the time they go to the hospital they are very sick with their co-morbidities.