Heart attack death has declined across all regions of the United States but it remains proportionately higher in the South, according to a paperat the American College of Cardiology's 63rd Annual Scientific Session.
Though there are lots of associations and correlations made regarding why rates of cardiovascular disease vary by state and region of the country, facts are few about geographic variation in associated death rates.
A new retrospective analysis used
the Nationwide Inpatient Sample (NIS)
to examine heart attack in-hospital mortality by region and identified more than 12.9 million heart attack cases from 2000 to 2010. They looked for trends in in-hospital deaths, risk factors and procedures performed in different regions of the country.
The overall in-hospital death rate per 100,000 cases was highest in the South followed by the Midwest, Northeast, with the least occurring in the West. There was a significant discrepancy between heart attack deaths in whites and non-Asian minorities in the region (a 50 percent and 15 percent relative higher risk, respectively). The analysis also found a significantly higher occurrence of cardiovascular risk factors including diabetes, obesity, high blood pressure, high cholesterol and smoking in the southern states compared to other regions. Median household income was also much lower in this area, which led the authors to speculate on that as the cause rather than poor diet and exercise.
"Lower household income in the region may play a role by affecting the type of care people receive, how well they are able to manage their risk factors, how often they see their doctors, and whether they have access to the proper medications," said Sadip Pant, M.D., an internist with the University of Arkansas for Medical Sciences, and lead investigator of the study.
Pant hopes the study will raise awareness and drive efforts to develop a system to better serve heart patients in the South. The next steps for research will be to examine the number of procedures performed in each geographic region and how this affects the cost of care related to hospitalization due to heart attack.