When a relatively young celebrity dies, we often assume that it’s a suicide or drug overdose—not a “natural” death. But singer George Michael’s death at age 53 and actor Bill Paxton’s death at age 61, both from heart-related conditions, remind us that heart issues are not that uncommon in middle-aged adults. The triggers are much the same as in older people, with risk factors including a family history of heart disease, high blood pressure, smoking, obesity and stress.

George Michael’s lifetime of “hard living” likely contributed to his early death from dilated cardiomyopathy, myocarditis and fatty liver. In plain language, his heart was enlarged, weakened and inflamed, making it tough, and eventually impossible, for the heart muscle to pump blood effectively. George Michael had a history of alcohol abuse, which is a big risk factor.

Bill Paxton’s death was the result of a stroke and occurred 11 days after his surgery to replace his heart’s aortic valve and repair an aortic aneurysm. This surgery saves many lives, but there’s always the risk of stroke following surgery, particularly heart surgery. The lesson here is simply to make sure you seek medical help if anything feels not quite right in your chest, but Paxton may not have been able to prevent his death. Outside of surgical complication, the way to prevent stroke is similar to preventing heart disease: eat healthfully, exercise and don’t smoke.

Heart attacks in women are more likely to go undiagnosed than in men, because women’s symptoms are more subtle, including nausea, sweating and back pain. “Women often experience these symptoms and not your typical chest pressure and left arm pain that you see with men,” reports Dr. Marlon Everett, an interventional cardiologist at Advocate Trinity Hospital in Chicago. Everett recommends three measures you can take to reduce your risk for heart disease:

• Maintain blood cholesterol of less than 200 mg.

• Maintain healthy blood sugar levels, which can be checked with an A1c blood test.

• Don’t smoke!