James Gandolfini and Michael Gale couldn’t be more different.

Gandolfini’s performance as Tony Soprano, a mobster with heart on the HBO drama, The Sopranos, created an iconic television character. His larger than life persona was matched by the large frame Gandolfini, 51, carried.

The final scene in the last episode of The Sopranos was set inside an ice cream parlor. One could safely assume the actor was familiar with most of the flavors.

Gale, 61, works in the healthcare industry, is an avid cyclist, eats a lean diet, and, by all accounts, would not be familiar to HBO’s viewership.

Both men suffered massive heart attacks. And here they share a kinship: There was no early warning to indicate something was wrong.

Gandolfini was in Rome on vacation celebrating his son’s graduation from junior high school and was also scheduled to appear at the Taormina Film Festival in Sicily. He collapsed inside his hotel room. Gale was dining with his girlfriend at Duffy’s Sports Grill in Fort Lauderdale discussing a planned 100-mile bike ride in hilly Mount Dora when he collapsed at the table.

Gale is en route to Jupiter Island to meet his cycling friends for a 200k bike ride.

Gandolfini’s funeral is scheduled for Thursday at the Cathedral of St. John the Divine in New York City.

The overall risk for individuals over 35 is one in a thousand will die suddenly. About one-half of the 300,000 Americans who die from sudden cardiac arrest annually exhibit no previous warning signs. And 50 percent of cardiac arrests are first events.

In such case, “Death is the presenting event of underlying disease,” said Dr. Robert Myerburg, professor of medicine and physiology at the University of Miami Miller School of Medicine. Myerburg did not treat the actor. An autopsy last week confirmed that Gandolfini, who also starred on Broadway and in the crime movie, True Romance, died of a heart attack, “natural causes,” although the exact cause for the cardiac arrest was not immediately known.

The risk for females is lower pre-menopausal because of estrogen’s protective traits during the child-bearing years, but once past menopause, women quickly catch up to the men in their 50s.

“It’s quite interesting,” Dr. Adam Splaver, clinical cardiologist and director of echocardiography for the Memorial Health Care System in Hollywood, said of the attention sparked by Gandolfini’s sudden death. “The incidence is on the rise. Over two million people are expected to have an event. People at increased risk are those with a previous heart attack or with a weak heart and other risk factors such as being overweight, having that central beer belly. Cholesterol problems, in addition to being out of shape, all can increase the risk of cardiac disease.”

The take-home message from Gandolfini’s high-profile death at age 51: eat a healthy diet with a concentration on vegetables and fruits and exercise regularly.

“Don’t put yourself in the position to increase your risk,” Myerburg said.

Reducing body fat, especially if you are obese, and engaging in some form of exercise, which can include simple walking to getting your heart rate up, can make a big difference.

“You are shifting the odds in your favor by what you are doing,” Myerburg said.