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MILWAUKEE (AP) — Paul Ryan works out and watches his diet, but a new study shows that clean living can only go so far to help people like the vice presidential candidate overcome a strong family history of heart disease.

The study of 4 million people — the largest ever on heart risks that run in families — found that having a close relative die young of cardiovascular disease doubles a person’s odds of developing it by age 50. This risk was independent of other factors like high cholesterol, high blood pressure and diabetes, and was even higher if more than one close family member had died young.

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