HealthDay News — Only 3.3% of Americans are in ideal cardiovascular health, study findings indicate, and there is considerable between-state variation in CV health.

Jing Fang, M.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues analyzed data for 356,441 eligible participants from the state-based 2009 Behavioral Risk Factor Surveillance System telephone survey, focusing on seven CV metrics: hypertension, high cholesterol, smoking, body mass index, diabetes, physical activity, and fruit and vegetable consumption. The results were published in the Journal of the American Heart Association.

The researchers found that 3.3%  of the overall population was in ideal CV health (ideal health status on all seven metrics), while 9.9% was in poor cardiovascular health (zero to two of the seven metrics). The mean overall score (number of ideal metrics) was 4.42.

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There was variation between states in the percentage with ideal CV health, ranging from 1.2% in Oklahoma to 6.9% in the District of Columbia. With Illinois as the referent, the adjusted prevalence ratio of ideal cardiovascular health ranged from 0.38 in Oklahoma to 1.91 in the District of Columbia.

“In conclusion, this report provides estimates of CV health for all 50 U.S. states and the District of Columbia. The data can be used by state programs as a baseline assessment of cardiovascular health,” the researchers wrote. “Findings from this report can be used by stakeholders to direct communication initiatives, focus limited resources, and support programmatic plans to improve cardiovascular health.”

Understanding differences in cardiovascular health by state is key to meeting public health goals, Donna Arnett, PhD, MSPH, of the University of Alabama at Birmingham School of Public Health and AHA president, wrote in an accompanying editorial.

Why are BMI, physical activity, and diet more heterogeneous among the states than smoking, diabetes, hypertension, and cholesterol?” she asked. “What is it about the demographics, culture, and public health efforts (or other characteristics) of Washington, DC, and Vermont that make them contrast so sharply with Oklahoma and West Virginia?”

Arnett agreed that understanding state by state differences in CV health can help focus resources to where they’re needed the most, but added that efforts are also needed to help customize interventions to specific groups.


  1. Fang J et al. J Am Heart Assoc. 2012; 1: e005371.
  2. Arnett DK et al. J Am Heart Assoc. 2012; 1: e006114.