Keto Fast 700 mg lead us in this discussion is my colleague jeff tudeberg so jeff is a cardiology professor at stanford he came to stanford in 2017 and currently heads the division that is concerned not only with heart failure but also with heart transplantation and the use of devices that give the heart a bit of a boost jeff is one of my just a couple of years ago in 2015 there were about six million people with with heart failure in the country and that's estimated to go up to almost 8 million in another 10 years or so so about a 40 increase over a relatively short period of time heart failure is some something that's everywhere in the country but there's areas that are it's more prevalent meaning that it's more common than others um in the sort of the south and through the appalachian mountains it tends to be a little bit more common but again this is disease that's just spread throughout the entire country so you can't really go very far without running into somebody who has been diagnosed with heart failure not only is heart failure common but