As noted earlier, people with diabetes are at higher risk for heart disease than those without. People who have high blood pressure are also at higher risk than those with normal blood pressure. People who have a cluster of metabolic disorders, characterized as the metabolic syndrome, are at a much greater risk for heart disease. Often, these diseases do not give any warning before they occur, and many people go for years without knowing they have them — and therefore without intervening. This chapter reviews some of these threatening silent killers in more detail and what you can do to address them.