Award-winning Sopranos actor James Gandolfini died Wednesday in Rome from an apparent heart attack.

Award-winning actor James Gandolfini had several common risk factors for a heart attack.

He died Wednesday after a family member found him unresponsive in a hotel room in Rome, where they were vacationing. Emergency workers attempted to resuscitate him for 40 minutes before he was declared dead at Umberto I hospital, according to Reuters.

Gandolfini was most famous for his portrayal of Tony Soprano, a New Jersey crime boss who saw a therapist and liked to feed ducks in the wildly popular HBO series The Sopranos. During his six years playing Soprano, Gandolfini was awarded an Emmy and a Golden Globe.

He used his money, fame, and influence to bring attention to the mental health of U.S. soldiers returning from Iraq in the documentary Alive Day Memories: Home From Iraq.

While the heart attack was unexpected, Gandolfini’s diet, weight, and alcohol consumption made him a prime candidate for heart troubles.

Heart disease is the No. 1 killer of Americans and is responsible for one in every four deaths. The U.S. Centers for Disease Control and Prevention estimates that about 600,000 people die from heart disease—a blanket term for several heart-related conditions—and an average of 715,000 people have a heart attack every year.

While the majority of heart attack victims are over the age of 65, men in their 50s are still likely candidates. Pre-menopausal women usually have a lower risk of heart disease, but their protection typically ends after menopause.

Gandolfini’s large frame was one outward sign of potential heart troubles, as obesity is a risk factor for heart disease, but family members say he never complained of heart troubles, according to media reports.

Earlier in his life, Gandolfini struggled with alcohol and cocaine use, two other factors that increased his chances of having a heart attack. His alcoholism was something he admitted to publicly, and his last meal was rumored to be fried food and eight alcoholic drinks.

If Tony Soprano were real, his short temper, cigar smoking, red meat-rich diet, and stressful life filled with panic attacks and sociopathic tendencies also would have made it hard on his heart.

Known risk factors for heart disease, according to the American Heart Association, include, but are not limited to, stress, excessive alcohol consumption, a high-fat and high-sodium diet, smoking, high cholesterol, high blood pressure, a sedentary lifestyle, obesity, diabetes, and being over the age of 65.

Photo of Gandolfini courtesy of Isabelle Vautier via Wikimedia Commons.