News | January 16, 2013

Americans' Heart Health Varies Significantly From State to State

Report could help state officials set goals to reduce risk of heart attack, stroke

January 16, 2013 — Americans' cardiovascular health varies greatly from state to state, according to new research in the Journal of the American Heart Association (JAHA). The study is the first to assess cardiovascular health at the state level.

"Since the Centers for Disease Control and Prevention (CDC) is funding state heart disease and stroke prevention programs, we thought it would be helpful to have cardiovascular health information on the state level, to help better focus our efforts," said Jing Fang, M.D., M.S., an epidemiologist with the CDC's Division for Heart Disease and Stroke Prevention in Atlanta.

Using 2009 data from the Behavioral Risk Factor Surveillance System — a telephone survey of more than 350,000 people in all 50 states and Washington, D.C. — researchers collected information on the American Heart Association's (AHA) seven major heart-health factors: blood pressure, total cholesterol, smoking, body mass index, diabetes, physical activity, and fruit and vegetable consumption. These factors are used as a proxy measure in this study for a healthy diet.

Researchers found:

The percentage of the population reporting ideal cardiovascular health (defined as having optimal levels of all seven factors) was lowest in Oklahoma, West Virginia and Mississippi, and highest in Washington, D.C., Vermont and Virginia.

  • About 3 percent of the total U.S. population reported having ideal heart health.
  • About 10 percent of the total population reported having poor cardiovascular health, with two or less heart health factors at optimal levels.
  • In general, people living in Western and New England states reported having a higher percentage of ideal cardiovascular health.


"Americans reported having, on average, more than four of the seven risk factors for heart disease," Fang said. "We also found large disparities by age, sex, race/ethnicity and levels of education."

  • Those who were 65 or older reported the lowest percentage of ideal heart health, while those aged 35 to 54 reported the highest percentage of ideal heart health.
  • Women said they were faring better than men.
  • Whites and Asian/Pacific Islanders reported highest rates of heart health while blacks, Native Americans and Alaska Natives fared most poorly.
  • Those in the highest education group reported better health than the other groups.


Estimates in the report could help those charged with preventing heart disease and stroke set statewide goals for reducing risk and improving cardiovascular health. "This study gives us important information about the factors and behaviors that need the most improvement in each state to achieve the AHA's goal of improving cardiovascular health for all Americans," Fang said.

The association’s goal is to improve the cardiovascular health of all Americans by 20 percent while reducing deaths from cardiovascular diseases and stroke by 20 percent, all by the year 2020.

"The comparisons offered by Fang and colleagues illustrate a critical point: Cardiovascular health status in the United States varies considerably by age, sex, race/ethnicity and education as well as by state," said Donna Arnett, Ph.D., president of the American Heart Association and author of an editorial that accompanies the Fang paper in JAHA. "This diversity necessitates that innovative, customized strategies be developed to most effectively improve cardiovascular health for specific states and among subpopulations."

Co-authors are Quanhe Yang, Ph.D.; Yuling Hong, M.D., M.Sc., Ph.D.; and Fleetwood Loustalot, Ph.D., F.N.P. Author disclosures are on the manuscript. The CDC funded the study.

For more information: http://newsroom.heart.org/pr/aha/_prv-americans-heart-health-varies-241864.aspx

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