Half of heart disease deaths could be prevented


Former Executive Editor, Harvard Health

Heart attack, stroke, and other cardiovascular diseases kill nearly three-quarters of a million Americans each year. They are the leading cause of death, accounting for nearly 30% of all deaths in the United States. But according to a new study published online yesterday in the Annals of Internal Medicine, many of these deaths can be prevented.

For the study, researchers from the Rollins School of Public Health at Emory University in Atlanta looked at cardiovascular death rates in each of the 50 states and the District of Columbia. They also tallied the rates of five so-called modifiable risk factors, or factors under a person’s control, that affect the risk of cardiovascular disease. These include smoking, high cholesterol, high blood pressure, type 2 diabetes, and obesity.

Death rates due to cardiovascular disease spanned a surprising range across the nation. Mississippi topped the list, with 477 deaths for every 100,000 residents. That was more than double the rate in Minnesota, which had the lowest rate at 195 per 100,000 residents. In general, Southern states had the highest rates. (See the list below.)

Nationwide, 4 out of 5 people had at least one modifiable risk factor for cardiovascular disease. The state-by-state distribution showed that people in Southern states tended to have more risk factors than residents of other states.

What would happen if these five risk factors disappeared — that is, what if all smokers quit, all obese people lost weight, and so on? The researchers calculated that eliminating these five factors would prevent more than half of all U.S. deaths from cardiovascular disease. Realizing that elimination may not be possible, they asked what would happen if, as a nation, we were able to do as well as the residents of the best-performing states. The result was a more modest 10% reduction in cardiovascular disease–related deaths.

“Since 1960, deaths from cardiovascular disease in the U.S. have been reduced by half,” said cardiologist Dr. Gregory Curfman, Editor in Chief of Harvard Health Publishing. “But we still have a long way to go. Further reducing the death rate by focusing on five modifiable risk factors is a critical goal for all Americans.”

Protecting your heart

Some of the things that cause or contribute to cardiovascular disease — genes, age, air pollution, buildings or neighborhoods that aren’t conducive to walking — are beyond an individual’s ability to change. But there are many other factors we can control. As the Emory study and others point out, modifiable risk factors are at the root of many cases of cardiovascular disease.

Here are five of the most important things you can do to protect your heart:

  • Exercise often.
  • Eat healthfully.
  • Keep your blood pressure, cholesterol, and blood sugar under control.
  • Lose weight if needed.
  • Don’t smoke.

Cardiovascular deaths rates for all 50 states and the District of Columbia.

State Deaths per 100,000 residents
Mississippi 477.0
District of Columbia 440.9
Alabama 434.5
Louisiana 424.0
Oklahoma 414.9
Arkansas 405.4
Tennessee 393.0
Kentucky 385.5
West Virginia 371.3
South Carolina 370.0
Georgia 368.6
Nevada 358.5
Missouri 346.7
Indiana 337.3
Michigan 333.1
Ohio 325.3
North Carolina 323.9
Texas 323.5
Maryland 315.2
Illinois 309.7
Pennsylvania 304.6
New York 297.7
Delaware 296.6
Virginia 291.1
Wyoming 290.9
Iowa 284.1
Kansas 280.8
Alaska 271.4
Florida 267.3
North Dakota 266.4
California 265.5
New Jersey 263.9
Wisconsin 262.4
South Dakota 258.1
Hawaii 257.3
Montana 256.0
Rhode Island 252.6
Idaho 251.5
Arizona 249.9
New Mexico 249.4
Washington 243.9
Nebraska 243.4
Maine 235.7
Connecticut 232.5
Vermont 231.9
Oregon 231.5
Massachusetts 228.0
New Hampshire 226.6
Colorado 219.3
Utah 217.8
Minnesota 195.2


Source: Shivani A. Patel and others, “Cardiovascular Mortality Associated With 5 Leading Risk Factors: National and State Preventable Fractions Estimated From Survey Data” Annals of Internal Medicine; published online June 29. 2015

Related Information: Diagnosis: Coronary Artery Disease


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  3. Kishan Vasekar

    Excellent study.As an extension ,if we can clearly identify factors for lowest deaths in MN as compared to Misssissipi , following factors are likely to emerge.
    1 Diet 2.Exercise and levels of physical activity.3 Ethnic differences and genetic build up .3Quality of sleep and hours 4 Family orientation and job stress 5 Obesity 6 Diabetes 7 Smoking and drinking habits and probably some small contribution by the most acclaimed Villain CHOLESTEROL..Even a simple reasoning will lead us to conclusion that Cholesterol levels are really the result of unhealthy lifestyle , except in genetic disorders.The greatest irony is that Statin studies show that it causes Diabetes , Liver dysfunction and still prevents death from heart attack.I once again appeal to AHA to consider restricting Statins to very limited cases and saving the humanity.Thanks

  4. drwho13

    Except for DC, the top 10 unhealthy heart States are “Red States.”

  5. Dr. Sunny Sharma

    Nice article! Collection of stats is really good.

  6. http://www.dcalling.com

    Golden Rules!
    Exercise often. Eat healthfully.
    Keep your blood pressure, cholesterol, and blood sugar under control. Lose weight if needed. Don’t smoke.

  7. Fred

    It is a shocking statistic, especially considering that cardiovascular diseases can be prevented to a large extent by following a heart-healthy lifestyle! Modern lifestyle comes with a lot of health hazards and it is important that we follow healthy habits. Thanks for sharing great tips to maintain better heart health!

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