ATLANTA, Nov 09 (Reuters Health) -- There is a five-fold difference in coronary heart disease (CHD) mortality between states with the lowest rates and states with the highest rates, according to a report presented here at the 72nd Scientific Sessions of the American Heart Association.
Among white men, aged 35 to 44, CHD mortality rate is lowest in Kansas, at 18 deaths per 100,000. It is highest in Tennessee, at 47 deaths per 100,000. Among black men in the same age group, CHD mortality is lowest in New Jersey, at 28 deaths per 100,000, and highest in Mississippi at 89/100,000.
This is the first study of heart disease rates to include only male "baby boomers."
"We focused on men between the ages of 35 and 44 because of dramatic lifestyle changes since World War II," Dr. Akira Sekikawa of the University of Pittsburgh School of Public Health explained during his presentation. "There is less cholesterol consumption, better control of hypertension, but increasing obesity and diabetes."
Sekikawa reported a three-fold variation in mortality rates between the states for whites and for blacks, but when CHD mortality among all men was considered, the variation between states was five-fold. Overall, deaths from CHD are 1.5 times higher among blacks than among whites, Sekikawa added.
The Pittsburgh investigator noted that since 1994, when the study was initiated, mortality rates in certain regions have remained consistently high or consistently low, although the specific numbers might change slightly. States with consistently low CHD mortality are Kansas, Connecticut, and Nebraska. States with consistently high CHD mortality are Mississippi, Kentucky, and Tennessee.
Internationally, Poland has the highest rates of CHD mortality, but deaths among black men in Mississippi, Missouri and South Carolina exceed even those rates, Sekikawa noted. Rates in Colorado, Utah and Washington are similar to those of France, which has CHD mortality rates in the range of 10-20/100,000.
CHD mortality correlated strongly with cigarette smoking, which the research team estimates by using lung cancer mortality data. States with the highest rates of cigarette smoking -- Kentucky and Tennessee -- also had the highest rates of heart disease deaths.
"In the United States, heart disease deaths are strongly associated with both cigarette smoking and, to a lesser degree, with educational level," said researcher Dr. Lewis H. Kuller in a University of Pittsburgh statement.
"These differences tell us a great deal about a huge public health problem -- the inequality of heart disease in this country," he added.
