None of us ever really wants to think about death — let alone talk about how we might die.

Chronic ischemic heart disease is the most common specific cause of death, followed by malignant lung cancer and chronic obstructive pulmonary disease (COPD).

But the fear often prevents us from having a valuable conversation in terms of living a better life and taking the steps necessary to stave off deadly diseases in the first place.

Many of the top killers are largely preventable. But how much are we really taking stock of our diet, exercise, sleep, or stress level so that we might avoid heart disease or cancer?

These remain the leading causes of death in the U.S., for the record. In 2014, there were 614,348 deaths from heart disease, 591,699 from cancer and 147,101 from chronic lower respiratory diseases, data from the Centers for Disease Control and Prevention shows.

Accidents and unintentional injuries followed with 136,053 deaths, while there were 133,103 deaths from stroke.

Other top causes included Alzheimer’s disease; diabetes; influenza and pneumonia; nephritis, nephrotic syndrome (a group of symptoms that include protein in the urine, low blood protein levels in the blood, high cholesterol levels, high triglyceride levels, and swelling) and nephrosis; and suicide.

A more granular search by HealthGrove on the 2014 data found that chronic ischemic heart disease was the most common specific cause of death, followed by malignant lung cancer and chronic obstructive pulmonary disease (COPD).

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The takeaway: Our lifestyles put us at risk for some diseases, as does the natural process of aging.

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Sabrina Perry, who compiled the report, said it was interesting to note that mental diseases were relatively uncommon until around age 70. The number of people who die from things such as Alzheimer’s disease and stroke increased in the 70-and-up age range.

With increased life expectancy and the baby boomer generation inching closer to those ages, we might see a higher prevalence of those diseases in the future, she said.

Trends to Pay Attention to
Major strides, meanwhile, have been made in combating cardiovascular diseases, even though it’s still the leading cause of death in the U.S., said Dr. Michael Miller, a professor of cardiovascular medicine, epidemiology and public health at the University of Maryland School of Medicine in Baltimore, Maryland.

“Preventing and treating diabetes should be considered a great concern,” said one clinical professor.

Rates peaked in the 1960s, leveled off from 1970 to 2000 and have declined about 35 to 40 percent over the past 15 years. Lower rates of smoking, as well as better control of risk factors such as high cholesterol and hypertension, are a few reasons for the decline.

“Still, we have a long way to go — rates of type 2 diabetes, a major heart disease risk factor have skyrocketed,” he noted. Miller said there were 2 to 3 million diabetics in the U.S. during the 1960s, a number that will soon reach 30 million (right now the CDC puts it at 29 million).

Let’s Talk about Prevention
It is rare for diabetes to directly cause death, but it’s “unfortunately terribly frequent for diabetes to itself cause many of the other conditions leading to death,” Dr. Zachary T. Bloomgarden, a clinical professor at the Icahn School of Medicine at Mount Sinai in New York City said.

“Diabetes is a cause of heart disease, stroke, and also of cancer, Alzheimer’s disease, and kidney disease,” he added.

A 2016 study found that diabetes was linked with more than a 10-year loss of life expectancy in men and women, smokers and nonsmokers, in all ethnic groups. That was also found to a greater extent in younger people and people with pre-existing heart disease.

That’s why preventing and treating diabetes should be considered a great concern, Bloomgarden added.

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Chronic ischemic heart disease, stroke, and heart attack are all very closely related and can be prevented by statins, added Dr. David Gortler, a former FDA senior medical officer and current drug safety and FDA policy expert at FormerFDA.com.

“There is even some preliminary data that strongly indicates statin use may prevent Alzheimer’s disease,” he told LifeZette. “The problem is that less than 30 percent of Americans are taking one of seven different available statins. There is epidemiological data which suggests that about 50 percent of Americans should be on a statin — so we are clearly not meeting our goal here.”