Special Report

Cities With the Lowest Risk of Heart Attack

Thomas C. Frohlich, Michael B. Sauter

Heart disease is the leading cause of death in the United States, accounting for one out of every four deaths each year. Some estimate the costs of heart-related health problems will rise to as high as $3.6 trillion annually within a decade. Cardiovascular problems can lead to heart attacks, which range from undetectable, minor incidents to heart failure and death. The prevalence of heart disease varies considerably across the United States.

24/7 Wall St. reviewed reviewed the incidence of heart attack in 190 U.S. metropolitan areas. We examined the percentage of adults in each area who have been told by a medical practitioner that they have had a heart attack. These data came from “2015 Community Rankings for Incidence of Heart Attack,” a report from Gallup-Healthways. Boulder leads the nation as the city where the smallest percentage of adults have had heart attacks.

Five of the 16 cities with the lowest prevalence of heart attack are in California, while most of the remaining areas are located across the midwest and southwestern United States. In a study tracing heart disease mortality from 1973 to 2010 that was published in March, CDC researchers found that the geographic patterns of heart-related deaths have shifted dramatically. While 40 years ago the highest heart disease mortality was concentrated in the Northeast, death rates have fallen dramatically in the region. Today, the highest concentration has shifted to the South.

Click here to see the cities where the fewest people have heart attacks.

Click here to see the cities where the most people have heart attacks.

Dr. Matthew Ritchey, an epidemiologist with the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention, said in an email to 24/7 Wall St.,

“The consistent progression southward over the past few decades suggests that the pattern is not random – and could be attributed to geographic differences in community-level prevention and treatment opportunities.”

Gallup’s report highlighted the heavy toll heart disease takes on individuals, families, and caregivers. Individuals with a history of heart attack are considerably more likely than those who have never been diagnosed to miss work and be admitted to a hospital, for example. The average American reports seven physically or mentally unhealthy days in a given month. Most of the 15 metros with the lowest prevalence of heart attacks report fewer unhealthy days in a month compared to the national average.

Certain behaviors and health conditions are known to increase the risk of heart attack. In the metros with the lowest incidence of heart attacks, these behaviors and conditions tend to be less common. Ritchey noted the prevalence of heart attacks largely depends on “the degree of heart attack risk factors a community has, which include poor blood pressure control, high cholesterol levels, smoking, obesity and physical inactivity.”

Only three of the 15 metro areas on this list have a smoking rate that exceeds the national adult smoking rate of 17%. Similarly, the obesity rate in just five of the 15 areas exceeds 30%, higher than in most metropolitan areas.

A range of socioeconomic factors appear related to a low prevalence of heart attack. High educational attainment in a population often accompanies positive health outcomes. A college degree helps ensure a decent wage — income needed for medical expenses, accessing exercise venues, alleviating stress from finances, etc. — and is often directly related to healthy choices that lower the risk of heart disease.

To identify the cities where the lowest percentage of adults have had heart attacks, 24/7 Wall St. examined “2015 Community Rankings for Incidence of Heart Attack,” a Gallup-Healthways report that reviewed 190 U.S. metropolitan areas. Gallup’s survey was based on 353,983 telephone interviews with U.S. adults across all 50 states and the District of Columbia and was conducted from January 2, 2014 to December 30, 2015. Participants were asked, “Have you ever been told by a physician or nurse that you have had a heart attack?” The percentage of adults with high blood pressure, high cholesterol, a history of diabetes or depression, as well as the obesity rate also came from Gallup. Median household income, poverty rate, and educational attainment came from the U.S. Census Bureau’s 2015 American Community Survey. The smoking rate came from County Health Rankings and Roadmaps.

These are the cities with the lowest risk of heart attack.