Where you live may help predict risk of early death from heart disease

November 07, 1999

ATLANTA, Nov. 8 -- The state in which you live may help predict your risk of early death from heart disease, according to research being presented today at the American Heart Association Scientific Sessions.

Researchers have found striking variations in heart disease rates throughout the U.S. The study looked at 1994 death rates from heart disease in young men between the ages of 35 and 44. The study group is the first comprised entirely of male baby boomers born after World War II.

"The reason we were interested in this specific group of men is because we believe that lifestyle is a major factor in early death from heart disease," says lead researcher Akira Sekikawa, M.D., Ph.D, an epidemiologist at the University of Pittsburgh School of Public Health.

Genes can play a role in increasing an individual's risk of premature cardiac death. But the study looks at populations, so the effects of genetics on this age group would be the same across the population. Thus, any regional variation observed would be due to other factors such as lifestyle. Furthermore, researchers say that most deaths in this age group are sudden deaths that occur outside of a hospital. "This also suggests that these deaths are due to lifestyle rather than medical care, says Sekikawa. "If we could learn how lifestyle contributed to these deaths we could better target programs aimed at preventing early death from heart disease."

Not surprisingly, researchers found that states with the highest rates of cigarette smoking -- Kentucky and Tennessee -- also had the highest rates of heart disease deaths. The researchers say that if cigarette smoking declined in those states the number of early deaths from heart disease would also decline.

The researchers also found that male residents of some states have five times the risk of dying young from heart disease compared to other states. And their analysis also challenges some common ideas about high-risk groups. "The general perception is that death rates are much higher in African Americans males compared to Caucasians," Sekikawa says. "But we found considerable variation from state to state. For example, in 1994, African Americans in Mississippi, ages 35 to 44, had a death rate of 89 per 100,000. In New Jersey, the death rate for that group was 28 per 100,000, a rate very similar to that of Caucasians in that state -- 26 per 100,000."

The regional differences were seen in the death rates for Caucasians. In Tennessee, Caucasian males had a death rate of 47 per 100,000, compared to a rate of 18 per 100,000 for Kansas -- the state with the lowest heart disease death rate.

The researchers also found a link between educational levels and the risk of early death from heart disease. States with the highest number of men who did not graduate from high school also had the highest mortality rates, whereas the states with the most male high school graduates had the lowest mortality rates. "We found dramatic differences among the states with regard to early death from heart disease," says study co-author Lewis H. Kuller, M.D., Ph.D, professor and chairman of epidemiology at the University of Pittsburgh School of Public Health. "In the United States, heart disease deaths are strongly associated with both cigarette smoking and, to a lesser degree, with educational level. These tremendous differences throughout the U.S. are due to the differences in lifestyles.

"These differences tell us a great deal about a huge public health problem -- the inequality of heart disease in this country," says Kuller.
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Media advisory: Dr. Sekikawa can be reached by email at akira@pitt.edu . Dr. Kuller can be reached by phone at (412) 624-2607(Please do not publish numbers or email.)

American Heart Association

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