Pinpoints Trouble Spots For Heart Disease

Heart disease is more common in Arizona, Florida, Kentucky, Louisiana, Missouri, Oklahoma and Texas, and least common in the U.S. Virgin Islands, according to the government's first state and territorial estimates of people living with heart disease nationwide.

Several of the states with the highest heart disease rates lie in a swath of Southeastern states known for high-fat diets. States reporting the lowest heart disease rates lie mainly in the West and Midwest: Nebraska, Wisconsin, Wyoming, New Mexico, Montana, Utah and Colorado.

Some states and territories had twice the prevalence of heart disease of others, the Centers for Disease Control and Prevention reports. Heart attack prevalence ranged from a high of 6.1% in West Virginia to 2.1% in the U.S. Virgin Islands. West Virginia residents also had the highest prevalence of heart disease and/or heart attacks at 10.4%. The Virgin Islands had the lowest at 3.5%.

"The magnitude of the difference was striking," says the study's lead author, Jonathan Neyer of the CDC's division for heart disease and stroke prevention.

Heart disease has been the nation's biggest killer for nearly a century and could cost the economy $151 billion this year for medical care, lost productivity and other direct and indirect costs. Yet doctors have lacked reliable state-by-state information to enable them to determine where to target prevention programs.

The new study provides that data, Neyer says, filling the gap between surveys showing how many people suffer from heart disease risk factors and how many people die of heart disease. The new survey, he says, supplies the estimated prevalence of people "actually living with heart disease."

The study revealed disparities based on education and race. The heart disease prevalence was nearly twice as high among people with less than a high school diploma as it was among college graduates, 9.8% vs. 5%. American Indians and Alaska natives reported a prevalence of 11%, compared with 4.7% among Asians. Blacks, Hispanics and whites reported heart disease prevalence ranging from 6% to 7%.

The CDC analysis is in Friday's Morbidity and Mortality Weekly Report. The data come from the agency's 2005 Behavioral Risk Factor Surveillance System, a random phone survey. A total of 356,112 adults responded to the survey in 2005, the report says.

Overall, 6.5% of people said a doctor or health provider told them they had a heart attack, angina or coronary heart disease.

Although the risk factor surveillance system has been established for years, this was the first time all 50 states and territories provided information on heart disease.

The study's main drawback is that it is based on self-reported data, which are not always accurate.

"If you're asking somebody whether they have heart disease, they're not going to tell you unless they've seen a doctor and gotten diagnosed," says Harvard's Christopher Murray, author of a September study showing population-based differences in life expectancy that generally jibe with the new report.

Murray says other government surveys indicated that half of people with diabetes and high blood pressure know they have the conditions.

Neyer says diabetes and hypertension are often silent diseases; heart attacks and chest pain are less likely to go unnoticed.