IStock Photo 3733757 © Max Delson Martins Santos

According to a report released Friday from the CDC, almost half of Americans already have a chronic condition which could lead to a heart attack or stroke. And many don’t even know it.

Forty-five percent of adults have high blood pressure, diabetes, or high cholesterol, all strong risk factors for heart disease and stroke. Three percent have all three conditions, 13% have two, and nearly one out of seven are unaware of the true state of their health. This study is the first look at the combined impact of all three conditions.

Heart ailments kill more people in the US every year than cancer, HIV, and accidents combined. A person who is 20 years or older in the US has a 1 in 2.7 chance of having cardiovascular disease, and the risks go up with age: for a man aged 50, the odds are 1 in 1.93(51.8%) that he will receive that diagnosis at some point. For a woman of the same age, the odds are 1 in 2.55.

Type II diabetes is associated with the development of cardiovascular disease, and the country’s obesity epidemic has brought the number of people diagnosed with the disease to record levels. In 1980, the odds a person had been diagnosed with diabetes were 1 in 35.71; by 2007 the odds had skyrocketed to1 in 16.53. Based upon the most recent numbers available, the odds a person has diabetes—whether they know it or not—are 1 in 12.82.

Rising rates of obesity are to blame for much of the trend, and changes in diet and lifestyle are the key to prevention. For those who already suffer from hypertension, diabetes, or high cholesterol, losing weight and increasing physical activity are also key to managing—and often improving—their conditions.

So when it comes to choosing a couple of donuts or a bowl of oatmeal for breakfast, just remember: no one wants to be one of the approximately 119 million people who end up in the ER every year.