Heart disease and strokes are a very serious issue and the main causes of death 20 years ago, and even today. This means that something such as genetics or even diet is effecting health and heart problems leading to death.
Explanation:
the original line is stating that heart disease and strokes were the two leading killers 20 years ago, and they still are today so this means that heart issues are a big problem and main cause of death.
That across the world heart disease and stroke were at the top of the list of issues that taking people's lives 20 years ago, and still remain fatal today!
