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When Tim Russert died suddenly last month of a heart attack, many Americans felt they had lost a friend. It was more than his boy-from-Buffalo charm, however, that connected Russert with the general public.

While the shock of losing such a popular figure at only 58 years of age, probably close to the median age of his viewing audience, sent the news media into a tizzy, he is only one of hundreds of thousands of Americans who will die of heart disease this year.

According to the American Heart Association, coronary disease is the No. 1 cause of death in the United States, and for many, key symptoms of the disease don't even show up until it is too late.

"Tim Russert is an unfortunate example of what acute coronary disease can do," said Dr. Karen Aspry, a cardiologist at Memorial Hospital of Rhode Island in Pawtucket, "He was one of the unlucky ones where the first sign was a severe heart attack."

Aspry, along with other doctors in the area, have noticed a greater concern lately among patients coming in for appointments and asking about Russert's death. "People want to know - 'How does my situation relates to his (Russert's) situation?" said Dr. Joseph DiCola, a cardiologist at Sturdy Memorial Hospital in Attleboro.

"I've heard a lot of patients say 'If it could happen to him, it could happen to me,'" said Dr. John Kinch, chief of cardiology at Caritas Hospital in Norwood.

DiCola says 250,000 people who die of cardiac-related problems each year do so suddenly and without warning. Aspry said half the people who die of coronary disease have no prior knowledge that they were sick.

"Unfortunately, for a number of people, their first symptom will be sudden cardiac arrest," Kinch said.

As a result, Kinch said that one of the major concerns raised by Russert's death is the need to improve chances of survival for those who suffer sudden cardiac arrest out of hospital care.

"The mortality rate for heart attacks has improved - many people do survive," Kinch said. "But when it arises like it did for Russert - sudden cardiac arrest out of a hospital - mortality rates rise dramatically."

Much of the debate after Russert's death has centered on the need to improve survival rates out of hospital care, and Kinch said many view the automatic external defibrillator (AED) as the solution.

The AED is a portable device that checks for abnormalities in the heart's rhythm, and if necessary, can direct a rescuer on how to administer electric shocks to the victim.

Currently, AEDs are available in many public buildings and schools, but Kinch said there needs to be a greater number available to the public. Massachusetts is one of many states that have enacted laws requiring AEDs at certain locations, though currently health clubs are the only sites in Massachusetts (outside of medical facilities) required to own an AED.

The problem with creating greater accessibility, he said, is the cost of the device, which the American Red Cross estimates at $2,300 a piece. The Red Cross also recommends training courses for the general public, and says that emergency medical technicians and other first responders, such as police and firefighters are required to know how to use the equipment and are the most suitable candidates to administer the shocks.

There are laws, though, that protect the general population from liability if they attempt to save a life with an AED.

The high numbers of coronary disease in the U.S., however, suggests to doctors that the problem is more than just a lack of off-site care for sudden and unexpected heart attacks. Americans, they say, need to change their lifestyles.

"It's a shame for a guy as vibrant and outgoing as Russert to have his life cut short," Kinch said. "But when something like this happens, it brings the problem up to patients and makes them more aware of it - which is good because it helps people identify their own risks and change their lifestyles."

"Expensive treatments are not needed to prevent (coronary disease)," Aspry said. "Just basic healthy living."

On top of regular checkups with tests for risk factors, including blood pressure, weight, cholesterol, diabetes and family history, DiCola said patients should never ignore symptoms, regardless of how small they seem.

Chest pain, shortness of breath, dizzy spells, or anything out of the ordinary is enough to visit a doctor.

"Russert had problems for many years," DiCola said. "People in their 20s, 30s or 40s may not have these problems yet, but they need to be aware. Preventative care is the best care. The goal is not to get to Russert's point."