DANVILLE -- Two national figures, NBC newsman Tim Russet and comedian George Carlin, who wrestled with heart disease and recently died of heart failure had experienced early warning signs, which required careful management, according to Dr. Alfred Casale, surgical director of Geisinger's Heart Institute.

Russert, 58, died while recording a voice-over for Meet the Press, and Carlin, 71, died after being admitted to a Los Angeles hospital with chest pains.

Russert had been under a doctor's care for coronary artery disease. He was following a regime of exercise and cholesterol-lowering medication.

In 1995, Carlin received an angioplasty that included placement of a double stent to open narrowed coronary arteries. Afterward, he announced he would focus on following a healthier lifestyle that included better eating habits and quitting smoking.

"The recent loss of these two high-profile Americans reinforces the importance of managing cardiac risk factors every day," Dr. Casale said. "Although we can usually extend and improve the lives of patients with heart disease, events like these remind us that the battle is ongoing and somewhat uncertain."

Heart failure can be caused by four main factors: uncontrolled high blood pressure, heart attacks, too much alcohol or other toxins or viral infection of the heart.

Untreated, heart failure can cause shortness of breath, weakness and fluid buildup.

According to the Centers for Disease Control and Prevention, the death rate from heart disease in the U.S. has dropped by 50 percent from 1980 to 2000, due to improvements in medical treatment and a reduction of risk factors.

Dr. Casale offers this advice, "You can dramatically reduce your risk of heart disease, by taking a simple approach -- reduce your risk factors.

n Know and manage with you doctor your blood pressure, cholesterol and blood sugar

n Reduce stress

n Follow a healthy diet and avoid obesity

n Exercise regularly

n Don't smoke