Heart health worst in the South, best in Northeast

But the country as a whole is having trouble. Only about 3 percent of U.S. adults surveyed who don't have heart problems managed to meet all of seven criteria for cardiac well-being, such as ideal levels of weight, blood pressure, physical activity and diet.

On the other side, nearly 10 percent of those surveyed were in poor shape heart-wise, meeting two or fewer of the requirements. That number reached 16 percent in West Virginia, 14 percent in Alabama, Mississippi and Kentucky, and 13 percent in Louisiana.

"Disparity continues to exist in cardiovascular health in America, not just by social demographics like race, gender, age and education level, but also by state," said study lead author Dr. Jing Fang, an epidemiologist with the U.S. Centers for Disease Control and Prevention.

In the United States, heart disease is responsible for an estimated one-third of all deaths. However, researchers say death levels for cardiovascular disease have fallen significantly over the last four decades, and a lot of that has to do with people taking better care of their health.

The new study is based on a survey of more than 350,000 people in 2009 who didn't have existing heart disease or previous strokes. The study authors acknowledged that its design has a weakness because it relies on people's perceptions of their health instead of medical records.

The investigators examined whether the participants met seven criteria for ideal cardiac health set by the American Heart Association: no high blood pressure; no high cholesterol; no diabetes; a healthy weight; no smoking; at least 150 minutes a week of moderate physical activity or 75 minutes of vigorous physical activity; and a diet with five or more servings of fruit and vegetables a day.

The researchers adjusted their statistics so they wouldn't be thrown off by high or low numbers of participants of certain ages.

The state with the lowest percentage of residents with ideal cardiac health—1 percent—was Oklahoma. Washington, D.C., topped the list with nearly 7 percent, followed by the states of Vermont and Connecticut (nearly 6 percent) and Virginia (5 percent).

Why were people in such relatively good shape in Washington, D.C., which is largely populated by black Americans who often have poor heart health? Fang said the city stands out because it has low levels of obesity and high levels of people with healthy diets.

Residents in some Southern states, particularly in the Deep South, had higher levels of obesity, high blood pressure and smoking, she said.

It's clear that southerners are at higher risk of heart problems, according to health researchers who have identified a "stroke belt" in the South, where strokes are more common than elsewhere in the country. It includes North Carolina, South Carolina, Georgia, Mississippi, Alabama, Arkansas, Tennessee and Louisiana.

What can be done with the study findings? Donna Arnett, president of the American Heart Association and chair of epidemiology at the University of Alabama at Birmingham, said the findings are crucial to gauge the progress of her association's project to improve the country's heart health by 20 percent by 2020.

As for states, "they should be empowered to tailor their [health] programs to their population's specific needs," she added.

But what about states, such as some of those in the South, that are poor? "If funds are limited, it may not be about doing more, but doing smarter," Arnett said.

The study was published Dec. 19 in the Journal of the American Heart Association.

More information: For more about preventing heart disease, visit the U.S. National Library of Medicine.

Journal reference: Journal of the American Heart Association

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