> #2 killer in the US it’s likely for the circulatory system to be undergoing rapid change.

Primarily killing people past reproductive age though.

Those people still influence the young, though. They have a huge impact on their young childrens' diets and habits, and I think epigenetics can throw a wrench into things by affecting how genes are expressed based on environmental factors.

If you're talking about a mutation that will increase the reproductive success of your children(or more likely grandchildren in the case of reduced chance of a heart attack), then the advantage would have to be even greater because of the high chance that your descendants don't have the same mutation.

I'm not saying there's no natural selection occurring, but that saying that heart disease is the #2 killer of Americans out of context likely overstates the selection pressure heart disease causes.

Does it also impact fertility?

Heart disease can impact cognitive function, fertility, economic status, etc well before death.

Yes, but the vast majority of people who die from heart disease don’t develop it until they are older. Which is why it’s misleading to talk about it being America’s #2 cause of death when discussing evolutionary pressure.

Heart disease starts at a young age. Mentioning deaths is relevant to demonstrate how common it is, not that the only impact is death.

No it doesn’t. At least not normally. Google the prevalence rates of heart disease in people under 40.

About 0.6% of people under 40 have the most common type of heart disease

https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd...

Again pointing out that it is the 2nd most common killer vastly overestimates its evolutionary impact. The same is true of cancer.

Normal blood pressure increases steadily with age. https://www.idealbloodpressureinfo.com/blood-pressure-chart-... Target and maximum heart rates similarly decline from your teens.

The point where these get called a precursor to heart disease is largely semantics. But they do impact heath before it’s noticeable as a problem.

You’re trying awful hard to save your point.

Target heart rate declining and blood pressure rising with age in no way implies that most people who later die of heart disease are somehow less reproductively fit when they are younger.

You say that, but the connection seems likely which is my point. The indirect symptoms of heart disease such as loss of athleticism and cognitive function would be important.

Heredity is one of the stronger predictors of heart disease so it’s got a strong genetic component beyond diet and lifestyle. So, it’s really just a question of how early meaningful symptoms show up as the physical differences already exist during people’s reproduce years.

It seems like an obvious test if do differences in Forearm arteries have fewer heart attacks. And do they correlate with higher blood pressure in people’s 20’s to 30’x.

>You say that, but the connection seems likely which is my point. The indirect symptoms of heart disease such as loss of athleticism and cognitive function would be important.

Only if as you say the meaningful symptoms show up during common reproductive years.

So far I see no evidence that that is the case.

>Heredity is one of the stronger predictors of heart disease so it’s got a strong genetic component beyond diet and lifestyle.

Again there is no evidence that it is common that hereditary heart disease that generally affects people 50+ has meaningful symptoms during reproductive years.

And there is even less evidence that these symptoms are meaningful enough to impact fertility to such an extent that it creates significant short term evolutionary pressure.

You're taking 1 condition which is common in later life and saying: well maybe some people with that condition actually develop it earlier in life, and just maybe some people that develop it earlier have some externally significant symptoms, and maybe some of those people have specific symptoms that would make them less likely to reproduce all else being equal.

Each step of that funnel is a complete unknown, and each step diminishes the overall impact that genes that control the most common forms of hereditary heart disease have on reproductive fitness.

I agree. There are plenty of reasons why this could be happening, including reasons that have nothing to do with any sort of selection at all. I've updated my comment to clarify what I'm responding to.