Atlanta, GA - West Virginia, Puerto Rico, and Kentucky have the highest proportion of residents with heart disease, whereas Hawaii, Colorado, and the US Virgin Islands have the lowest, according to the results of a new study reporting on the prevalence of MI or angina/coronary heart disease throughout the United States [1].

The findings, published February 16, 2007 in the Morbidity and Mortality Weekly Report (MMWR), a publication of the Centers for Disease Control and Prevention (CDC), showed there to be significant variation in prevalence among states, with an approximate twofold difference between the states with the highest and lowest prevalence of disease. For example, more than 10% of residents of West Virginia and Puerto Rico and 8.8% of residents of Kentucky report a history of MI, angina, or coronary heart disease, whereas in Colorado and Hawaii just 4.8% and 4.9%, respectively, of those surveyed reported a history of heart disease.

The report, with first author Dr Jonathan Neyer (Centers for Disease Control and Prevention, Atlanta, GA), is based on data from the Behavioral Risk Factor Surveillance System (BRFSS), a state-based telephone survey of US citizens aged 18 years and older and administered by state health departments in collaboration with the CDC. More than 350 000 participants from all 50 states, the District of Columbia, Puerto Rico, and the US Virgin Islands were asked whether a doctor or other health professional had ever told them they experienced a "heart attack, also called a myocardial infarction" or "angina, or coronary heart disease."

In 2005, 4.0% of respondents reported a history of MI, 4.4% reported a history of angina/coronary heart disease, and 6.5% reported a history of one or more of these conditions. In addition to these state-by-state differences, men had a significantly higher prevalence of MI than women, and the prevalence of disease increased among successive age groups and decreased among those with higher education. In terms of ethnic differences, American Indians/Alaska natives and people of multiracial origin had a substantially higher prevalence of MI or angina/coronary heart disease than non-Hispanic whites. The prevalence of disease among blacks and whites was similar.

An editorial note accompanying the published report suggests that these new data can help policy makers and public-health officials "better target resources" to aid in the "development of tailored prevention programs for groups with disproportionately high heart-disease prevalence." In addition to the importance of preventing and controlling risk factors, community- and state-level policies "are needed to promote healthy lifestyles, help reduce tobacco exposure, ensure access to healthy foods, establish school and worksite heart-health education programs, and result in an environment that is safe and conducive to physical activity," the authors write.