Half of all deaths from heart disease could be avoided

Heart attacks, strokes and other cardiovascular diseases crashes 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 today in the Annals of Internal Medicine, most of these deaths are preventable.

For the study, researchers from the Rollins School of Public Health at Emory University in Atlanta analyzed the cardiovascular mortality rate in all 50 states and the District of Columbia. They also noted the rate of five factors known modifiable risk factors or under the control of a person that influence the risk of cardiovascular disease. These include smoking, high cholesterol, high blood pressure, type 2 diabetes and obesity.

Rates of cardiovascular disease mortality covered a wide range surprising across the country. Mississippi topped the list, with 477 deaths per 100,000 inhabitants. This was more than double the rate in Minnesota, which has the lowest rate to 195 per 100 000 inhabitants. In general, the southern states have the highest rates. (See list below.)

Nationally, 4 out of 5 people have at least one modifiable risk factor for cardiovascular disease. Distribution, state by state showed that people in the southern states tend to have more risk factors than residents of other states.

What if these five risk factors have disappeared - that is, if all smokers quit, all the obese people to lose weight, and so on? Researchers estimate that the removal of these five factors could prevent more than half of all deaths in the United States of cardiovascular disease. Realizing that the removal may not be possible, they asked what would happen if, as a nation, we have been able to do as well as residents of states with better performance. The result has been more modest 10% reduction in deaths from cardiovascular disease.

"Since 1960, deaths from cardiovascular disease in the United States have dropped by half," said cardiologist Dr. Gregory Curfman, editor in chief of Harvard Health Publications. "But we still have a long way to go. Reduce mortality further, focusing on five modifiable risk factors is a key objective for all Americans. " 

Protect your heart

Some of the things that cause or contribute to cardiovascular disease - genes, age, air pollution, buildings or neighborhoods that are walkable - are beyond the ability of the individual to change. But there are many other factors that we can control. As Emory study and others point out, modifiable risk factors are 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 healthy.
     *  Keep your blood pressure, cholesterol and blood sugar under control.
     *  Lose weight if necessary.
     *  No Smoking. 

The rates of cardiovascular death in 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: A. Shivani Patel et al, "The cardiovascular mortality associated with five major preventable risk factors: Fractions State national data survey estimates and the" Annals of Internal Medicine; published online 29 June 2015