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States Where the Most People Have Heart Disease

States Where the Most People Have Heart Disease

Though the COVID-19 pandemic has killed more than 220,000 Americans in 2020, it is not the top cause of death in the country. One in every four deaths in the United States, or 655,000 deaths a year, are caused by heart disease.

Heart disease is by far the leading cause of death for men, women, as well as for all people in most racial and ethnic groups.

24/7 Tempo reviewed the share of residents 18 or older who had a major cardiovascular disease in 2018, the latest year for which data is available, to determine the states with the largest and smallest share of the population suffering from heart disease.

On average, 7.4% of American adults had some form of major cardiovascular disease as of 2018 and 3.8% have suffered a heart attack, up from 6.9% and 3.6%, respectively, in 2015. Cardiovascular disease comprises conditions affecting the heart, the most common of which is coronary artery disease.

High blood pressure, high cholesterol, and smoking are major risk factors for heart disease. In addition to smoking, unhealthy behaviors such as poor diet — specifically eating a diet high in saturated fats, trans fat, and cholesterol — and lack of physical activity and excessive drinking also increase a person’s risk of developing a cardiovascular disease.

About 17.3% of adult Americans smoke, 29.0% are obese, and 23.6% don’t exercise regularly. In nine of the 10 states with the highest shares of adults with heart disease, at least 30.1% of adults are obese. The majority of states with the most heart disease have some of the largest percentage of adults who report physical inactivity and smoking.

Additionally, eight of those 10 states are also among the states with the highest premature mortality rates. Life expectancy is one of the most telling and often cited measures of the health of a given population — this is the least healthy city in every state.

Socioeconomic factors may play a role as people with low incomes may struggle to get access to health care, buy healthy food, or prioritize exercise. In eight of the 10 states with the highest shares of adults with cardiovascular disease household incomes are among the 10 lowest in the country. The median annual household income in these states is between $45,000 and $56,000, compared to a national median of over $65,000.

Source: f11photo / Getty Images

50. Colorado
> Adults with cardiovascular disease: 5.4% — the lowest
> Adults who’ve had heart attack: 2.9% — 3rd lowest
> Obesity rate: 21.8% — the lowest
> Smoking rate: 14.6% — 12th lowest
> People who don’t exercise: 15.5% — the lowest
> Adults who drink excessively: 20.5% — 12th highest
> Premature mortality rate: 282 per 100,000 residents — 7th lowest
> Median household income: $77,127 — 9th highest

Source: Adventure_Photo / Getty Images

49. Utah
> Adults with cardiovascular disease: 6.0% — 2nd lowest
> Adults who’ve had heart attack: 2.9% — 3rd lowest
> Obesity rate: 25.9% — 9th lowest
> Smoking rate: 8.9% — the lowest
> People who don’t exercise: 18.1% — 5th lowest
> Adults who drink excessively: 12.2% — the lowest
> Premature mortality rate: 289 per 100,000 residents — 9th lowest
> Median household income: $75,780 — 11th highest

Source: choness / Getty Images

46. California
> Adults with cardiovascular disease: 6.1% — 5th lowest
> Adults who’ve had heart attack: 2.7% — the lowest
> Obesity rate: 23.6% — 2nd lowest
> Smoking rate: 11.3% — 2nd lowest
> People who don’t exercise: 17.6% — 4th lowest
> Adults who drink excessively: 19.2% — 23rd highest
> Premature mortality rate: 270 per 100,000 residents — 2nd lowest
> Median household income: $80,440 — 5th highest

Source: RudyBalasko / Getty Images

46. Minnesota
> Adults with cardiovascular disease: 6.1% — 5th lowest
> Adults who’ve had heart attack: 3.3% — 9th lowest
> Obesity rate: 27.9% — 17th lowest
> Smoking rate: 14.5% — 11th lowest
> People who don’t exercise: 20.1% — 9th lowest
> Adults who drink excessively: 21.7% — 5th highest
> Premature mortality rate: 266 per 100,000 residents — the lowest
> Median household income: $74,593 — 13th highest

Source: Sean Pavone / Getty Images

46. Vermont
> Adults with cardiovascular disease: 6.1% — 5th lowest
> Adults who’ve had heart attack: 3.4% — 12th lowest
> Obesity rate: 26.3% — 10th lowest
> Smoking rate: 15.8% — 19th lowest
> People who don’t exercise: 19.1% — 6th lowest
> Adults who drink excessively: 19.5% — 21st highest
> Premature mortality rate: 301 per 100,000 residents — 11th lowest
> Median household income: $63,001 — 25th lowest

Source: Sean Pavone / Getty Images

43. Wisconsin
> Adults with cardiovascular disease: 6.2% — 8th lowest
> Adults who’ve had heart attack: 3.0% — 5th lowest
> Obesity rate: 31.3% — 22nd highest
> Smoking rate: 16.0% — 20th lowest
> People who don’t exercise: 20.8% — 13th lowest
> Adults who drink excessively: 24.2% — the highest
> Premature mortality rate: 308 per 100,000 residents — 16th lowest
> Median household income: $64,168 — 21st highest

Source: SeanPavonePhoto / Getty Images

43. Connecticut
> Adults with cardiovascular disease: 6.2% — 8th lowest
> Adults who’ve had heart attack: 3.0% — 5th lowest
> Obesity rate: 25.8% — 8th lowest
> Smoking rate: 12.7% — 3rd lowest
> People who don’t exercise: 20.4% — 10th lowest
> Adults who drink excessively: 17.1% — 15th lowest
> Premature mortality rate: 276 per 100,000 residents — 3rd lowest
> Median household income: $78,833 — 6th highest

Source: DenisTangneyJr / Getty Images

43. Massachusetts
> Adults with cardiovascular disease: 6.2% — 8th lowest
> Adults who’ve had heart attack: 3.5% — 14th lowest
> Obesity rate: 24.7% — 4th lowest
> Smoking rate: 13.7% — 6th lowest
> People who don’t exercise: 21.3% — 16th lowest
> Adults who drink excessively: 21.3% — 7th highest
> Premature mortality rate: 282 per 100,000 residents — 6th lowest
> Median household income: $85,843 — 2nd highest

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42. Hawaii
> Adults with cardiovascular disease: 6.3% — 9th lowest
> Adults who’ve had heart attack: 3.3% — 9th lowest
> Obesity rate: 23.7% — 3rd lowest
> Smoking rate: 12.8% — 4th lowest
> People who don’t exercise: 20.5% — 11th lowest
> Adults who drink excessively: 21.1% — 9th highest
> Premature mortality rate: 279 per 100,000 residents — 5th lowest
> Median household income: $83,102 — 4th highest

Source: DenisTangneyJr / Getty Images

41. New Hampshire
> Adults with cardiovascular disease: 6.4% — 10th lowest
> Adults who’ve had heart attack: 3.6% — 18th lowest
> Obesity rate: 27.9% — 17th lowest
> Smoking rate: 15.7% — 17th lowest
> People who don’t exercise: 21.3% — 16th lowest
> Adults who drink excessively: 20.7% — 11th highest
> Premature mortality rate: 308 per 100,000 residents — 14th lowest
> Median household income: $77,933 — 8th highest

Source: Davel5957 / Getty Images

38. Nebraska
> Adults with cardiovascular disease: 6.6% — 13th lowest
> Adults who’ve had heart attack: 3.1% — 6th lowest
> Obesity rate: 32.2% — 16th highest
> Smoking rate: 15.4% — 14th lowest
> People who don’t exercise: 23.3% — 25th lowest
> Adults who drink excessively: 21.7% — 4th highest
> Premature mortality rate: 310 per 100,000 residents — 17th lowest
> Median household income: $63,229 — 25th highest

Source: Chilkoot / Getty Images

38. Alaska
> Adults with cardiovascular disease: 6.6% — 13th lowest
> Adults who’ve had heart attack: 3.4% — 12th lowest
> Obesity rate: 32.5% — 14th highest
> Smoking rate: 21.0% — 9th highest
> People who don’t exercise: 20.0% — 8th lowest
> Adults who drink excessively: 21.3% — 8th highest
> Premature mortality rate: 356 per 100,000 residents — 20th highest
> Median household income: $75,463 — 12th highest

Source: pabradyphoto / Getty Images

38. Iowa
> Adults with cardiovascular disease: 6.6% — 13th lowest
> Adults who’ve had heart attack: 3.7% — 22nd lowest
> Obesity rate: 33.2% — 9th highest
> Smoking rate: 17.1% — 25th lowest
> People who don’t exercise: 23.7% — 24th highest
> Adults who drink excessively: 22.1% — 3rd highest
> Premature mortality rate: 319 per 100,000 residents — 19th lowest
> Median household income: $61,691 — 21st lowest

Source: Sean Pavone / iStock via Getty Images

37. Washington
> Adults with cardiovascular disease: 6.7% — 14th lowest
> Adults who’ve had heart attack: 3.2% — 7th lowest
> Obesity rate: 27.8% — 15th lowest
> Smoking rate: 13.5% — 5th lowest
> People who don’t exercise: 17.0% — 2nd lowest
> Adults who drink excessively: 17.4% — 20th lowest
> Premature mortality rate: 287 per 100,000 residents — 8th lowest
> Median household income: $78,687 — 7th highest

Source: Creative-Family / Getty Images

34. New Jersey
> Adults with cardiovascular disease: 6.8% — 17th lowest
> Adults who’ve had heart attack: 3.6% — 18th lowest
> Obesity rate: 26.4% — 11th lowest
> Smoking rate: 13.7% — 7th lowest
> People who don’t exercise: 26.0% — 13th highest
> Adults who drink excessively: 18.1% — 22nd lowest
> Premature mortality rate: 292 per 100,000 residents — 10th lowest
> Median household income: $85,751 — 3rd highest

Source: FilippoBacci / Getty Images

34. New York
> Adults with cardiovascular disease: 6.8% — 17th lowest
> Adults who’ve had heart attack: 3.6% — 18th lowest
> Obesity rate: 25.5% — 5th lowest
> Smoking rate: 14.1% — 9th lowest
> People who don’t exercise: 24.7% — 18th highest
> Adults who drink excessively: 18.8% — 25th lowest
> Premature mortality rate: 279 per 100,000 residents — 4th lowest
> Median household income: $72,108 — 14th highest

Source: vkbhat / Getty Images

34. Idaho
> Adults with cardiovascular disease: 6.8% — 17th lowest
> Adults who’ve had heart attack: 3.8% — 24th highest
> Obesity rate: 29.3% — 21st lowest
> Smoking rate: 14.3% — 10th lowest
> People who don’t exercise: 20.8% — 13th lowest
> Adults who drink excessively: 16.6% — 10th lowest
> Premature mortality rate: 308 per 100,000 residents — 15th lowest
> Median household income: $60,999 — 20th lowest

Source: aoldman / Getty Images

33. Wyoming
> Adults with cardiovascular disease: 6.9% — 18th lowest
> Adults who’ve had heart attack: 3.7% — 22nd lowest
> Obesity rate: 28.9% — 20th lowest
> Smoking rate: 18.7% — 17th highest
> People who don’t exercise: 24.1% — 22nd highest
> Adults who drink excessively: 19.8% — 15th highest
> Premature mortality rate: 342 per 100,000 residents — 22nd highest
> Median household income: $65,003 — 19th highest

Source: ferrantraite / Getty Images

32. New Mexico
> Adults with cardiovascular disease: 7.0% — 19th lowest
> Adults who’ve had heart attack: 3.8% — 24th highest
> Obesity rate: 26.6% — 13th lowest
> Smoking rate: 17.5% — 20th highest
> People who don’t exercise: 19.7% — 7th lowest
> Adults who drink excessively: 16.2% — 9th lowest
> Premature mortality rate: 394 per 100,000 residents — 13th highest
> Median household income: $51,945 — 6th lowest

Source: SeanPavonePhoto / Getty Images

31. Virginia
> Adults with cardiovascular disease: 7.1% — 20th lowest
> Adults who’ve had heart attack: 3.7% — 22nd lowest
> Obesity rate: 29.8% — 23rd lowest
> Smoking rate: 16.4% — 23rd lowest
> People who don’t exercise: 22.9% — 22nd lowest
> Adults who drink excessively: 17.4% — 19th lowest
> Premature mortality rate: 321 per 100,000 residents — 20th lowest
> Median household income: $76,456 — 10th highest

Source: DenisTangneyJr / Getty Images

30. North Dakota
> Adults with cardiovascular disease: 7.2% — 21st lowest
> Adults who’ve had heart attack: 4.2% — 20th highest
> Obesity rate: 32.7% — 13th highest
> Smoking rate: 18.3% — 18th highest
> People who don’t exercise: 23.9% — 23rd highest
> Adults who drink excessively: 24.1% — 2nd highest
> Premature mortality rate: 316 per 100,000 residents — 18th lowest
> Median household income: $64,577 — 20th highest

Source: Davel5957 / Getty Images

28. Maryland
> Adults with cardiovascular disease: 7.3% — 23rd lowest
> Adults who’ve had heart attack: 3.4% — 12th lowest
> Obesity rate: 31.0% — 23rd highest
> Smoking rate: 13.8% — 8th lowest
> People who don’t exercise: 22.4% — 21st lowest
> Adults who drink excessively: 16.6% — 11th lowest
> Premature mortality rate: 339 per 100,000 residents — 25th highest
> Median household income: $86,738 — the highest

Source: Sean Pavone / Getty Images

28. Illinois
> Adults with cardiovascular disease: 7.3% — 23rd lowest
> Adults who’ve had heart attack: 3.6% — 18th lowest
> Obesity rate: 29.7% — 22nd lowest
> Smoking rate: 15.5% — 15th lowest
> People who don’t exercise: 22.3% — 20th lowest
> Adults who drink excessively: 21.4% — 6th highest
> Premature mortality rate: 329 per 100,000 residents — 21st lowest
> Median household income: $69,187 — 17th highest

Source: pabradyphoto / Getty Images

26. Delaware
> Adults with cardiovascular disease: 7.4% — 25th lowest
> Adults who’ve had heart attack: 3.5% — 14th lowest
> Obesity rate: 30.9% — 24th highest
> Smoking rate: 17.0% — 24th lowest
> People who don’t exercise: 27.7% — 8th highest
> Adults who drink excessively: 16.8% — 13th lowest
> Premature mortality rate: 359 per 100,000 residents — 19th highest
> Median household income: $70,176 — 16th highest

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26. Montana
> Adults with cardiovascular disease: 7.4% — 25th lowest
> Adults who’ve had heart attack: 3.8% — 24th highest
> Obesity rate: 25.8% — 8th lowest
> Smoking rate: 17.2% — 25th highest
> People who don’t exercise: 21.6% — 18th lowest
> Adults who drink excessively: 20.9% — 10th highest
> Premature mortality rate: 336 per 100,000 residents — 24th lowest
> Median household income: $57,153 — 11th lowest

Source: pabradyphoto / Getty Images

25. South Dakota
> Adults with cardiovascular disease: 7.5% — 25th highest
> Adults who’ve had heart attack: 4.2% — 20th highest
> Obesity rate: 31.8% — 20th highest
> Smoking rate: 19.3% — 14th highest
> People who don’t exercise: 21.3% — 16th lowest
> Adults who drink excessively: 19.0% — 25th highest
> Premature mortality rate: 333 per 100,000 residents — 23rd lowest
> Median household income: $59,533 — 18th lowest

Source: Davel5957 / Getty Images

24. Kansas
> Adults with cardiovascular disease: 7.6% — 24th highest
> Adults who’ve had heart attack: 3.7% — 22nd lowest
> Obesity rate: 33.2% — 9th highest
> Smoking rate: 17.4% — 22nd highest
> People who don’t exercise: 24.8% — 17th highest
> Adults who drink excessively: 18.7% — 24th lowest
> Premature mortality rate: 351 per 100,000 residents — 21st highest
> Median household income: $62,087 — 24th lowest

Source: SeanPavonePhoto / Getty Images

23. Rhode Island
> Adults with cardiovascular disease: 7.8% — 23rd highest
> Adults who’ve had heart attack: 4.4% — 15th highest
> Obesity rate: 28.1% — 18th lowest
> Smoking rate: 14.9% — 13th lowest
> People who don’t exercise: 24.4% — 19th highest
> Adults who drink excessively: 19.6% — 17th highest
> Premature mortality rate: 304 per 100,000 residents — 12th lowest
> Median household income: $71,169 — 15th highest

Source: GMVozd / Getty Images

21. Arizona
> Adults with cardiovascular disease: 8.0% — 21st highest
> Adults who’ve had heart attack: 4.0% — 23rd highest
> Obesity rate: 27.5% — 14th lowest
> Smoking rate: 15.6% — 16th lowest
> People who don’t exercise: 21.8% — 19th lowest
> Adults who drink excessively: 16.7% — 12th lowest
> Premature mortality rate: 332 per 100,000 residents — 22nd lowest
> Median household income: $62,055 — 23rd lowest

Source: f11photo / Getty Images

21. Nevada
> Adults with cardiovascular disease: 8.0% — 21st highest
> Adults who’ve had heart attack: 4.4% — 15th highest
> Obesity rate: 25.7% — 6th lowest
> Smoking rate: 17.6% — 19th highest
> People who don’t exercise: 23.1% — 24th lowest
> Adults who drink excessively: 19.3% — 22nd highest
> Premature mortality rate: 364 per 100,000 residents — 17th highest
> Median household income: $63,276 — 24th highest

Source: 4nadia / Getty Images

19. Oregon
> Adults with cardiovascular disease: 8.1% — 19th highest
> Adults who’ve had heart attack: 3.8% — 24th highest
> Obesity rate: 28.8% — 19th lowest
> Smoking rate: 16.1% — 21st lowest
> People who don’t exercise: 17.2% — 3rd lowest
> Adults who drink excessively: 18.6% — 23rd lowest
> Premature mortality rate: 304 per 100,000 residents — 13th lowest
> Median household income: $67,058 — 18th highest

Source: SeanPavonePhoto / Getty Images

19. Pennsylvania
> Adults with cardiovascular disease: 8.1% — 19th highest
> Adults who’ve had heart attack: 3.8% — 24th highest
> Obesity rate: 30.3% — 25th highest
> Smoking rate: 18.7% — 16th highest
> People who don’t exercise: 23.1% — 24th lowest
> Adults who drink excessively: 19.2% — 24th highest
> Premature mortality rate: 359 per 100,000 residents — 18th highest
> Median household income: $63,463 — 23rd highest

Source: pawel.gaul / Getty Images

18. Michigan
> Adults with cardiovascular disease: 8.2% — 18th highest
> Adults who’ve had heart attack: 4.4% — 15th highest
> Obesity rate: 32.0% — 18th highest
> Smoking rate: 19.3% — 13th highest
> People who don’t exercise: 23.4% — 25th highest
> Adults who drink excessively: 19.6% — 18th highest
> Premature mortality rate: 368 per 100,000 residents — 16th highest
> Median household income: $59,584 — 19th lowest

Source: Sean Pavone / Getty Images

17. Georgia
> Adults with cardiovascular disease: 8.3% — 17th highest
> Adults who’ve had heart attack: 4.2% — 20th highest
> Obesity rate: 32.0% — 18th highest
> Smoking rate: 17.5% — 21st highest
> People who don’t exercise: 27.5% — 9th highest
> Adults who drink excessively: 14.4% — 7th lowest
> Premature mortality rate: 381 per 100,000 residents — 14th highest
> Median household income: $61,980 — 22nd lowest

Source: Paulaandreaonline / Getty Images

16. Maine
> Adults with cardiovascular disease: 8.5% — 16th highest
> Adults who’ve had heart attack: 4.9% — 7th highest
> Obesity rate: 29.9% — 24th lowest
> Smoking rate: 17.3% — 23rd highest
> People who don’t exercise: 21.6% — 18th lowest
> Adults who drink excessively: 20.2% — 13th highest
> Premature mortality rate: 337 per 100,000 residents — 25th lowest
> Median household income: $58,924 — 16th lowest

Source: DenisTangneyJr / Getty Images

12. Missouri
> Adults with cardiovascular disease: 8.6% — 12th highest
> Adults who’ve had heart attack: 4.3% — 19th highest
> Obesity rate: 32.2% — 16th highest
> Smoking rate: 20.8% — 11th highest
> People who don’t exercise: 25.8% — 16th highest
> Adults who drink excessively: 19.8% — 16th highest
> Premature mortality rate: 401 per 100,000 residents — 12th highest
> Median household income: $57,409 — 13th lowest

Source: SeanPavonePhoto / Getty Images

12. South Carolina
> Adults with cardiovascular disease: 8.6% — 12th highest
> Adults who’ve had heart attack: 4.4% — 15th highest
> Obesity rate: 32.9% — 12th highest
> Smoking rate: 18.8% — 15th highest
> People who don’t exercise: 25.9% — 14th highest
> Adults who drink excessively: 17.4% — 18th lowest
> Premature mortality rate: 413 per 100,000 residents — 9th highest
> Median household income: $56,227 — 10th lowest

Source: Kruck20 / Getty Images

12. North Carolina
> Adults with cardiovascular disease: 8.6% — 12th highest
> Adults who’ve had heart attack: 4.5% — 13th highest
> Obesity rate: 31.4% — 21st highest
> Smoking rate: 17.2% — 24th highest
> People who don’t exercise: 24.3% — 21st highest
> Adults who drink excessively: 16.9% — 14th lowest
> Premature mortality rate: 372 per 100,000 residents — 15th highest
> Median household income: $57,341 — 12th lowest

Source: Davel5957 / Getty Images

12. Ohio
> Adults with cardiovascular disease: 8.6% — 12th highest
> Adults who’ve had heart attack: 4.7% — 11th highest
> Obesity rate: 32.3% — 15th highest
> Smoking rate: 21.1% — 8th highest
> People who don’t exercise: 26.4% — 12th highest
> Adults who drink excessively: 20.2% — 14th highest
> Premature mortality rate: 408 per 100,000 residents — 10th highest
> Median household income: $58,642 — 15th lowest

Source: Sean Pavone / Getty Images

10. Texas
> Adults with cardiovascular disease: 8.7% — 10th highest
> Adults who’ve had heart attack: 4.7% — 11th highest
> Obesity rate: 30.1% — 25th lowest
> Smoking rate: 15.7% — 18th lowest
> People who don’t exercise: 24.4% — 19th highest
> Adults who drink excessively: 19.5% — 20th highest
> Premature mortality rate: 340 per 100,000 residents — 23rd highest
> Median household income: $64,034 — 22nd highest

Source: SeanPavonePhoto / Getty Images

10. Florida
> Adults with cardiovascular disease: 8.7% — 10th highest
> Adults who’ve had heart attack: 4.8% — 9th highest
> Obesity rate: 26.6% — 13th lowest
> Smoking rate: 16.1% — 22nd lowest
> People who don’t exercise: 25.9% — 14th highest
> Adults who drink excessively: 17.1% — 16th lowest
> Premature mortality rate: 339 per 100,000 residents — 24th highest
> Median household income: $59,227 — 17th lowest

Source: Sean Pavone / Getty Images

9. Indiana
> Adults with cardiovascular disease: 9.7% — 9th highest
> Adults who’ve had heart attack: 5.1% — 6th highest
> Obesity rate: 33.4% — 8th highest
> Smoking rate: 21.8% — 7th highest
> People who don’t exercise: 26.7% — 11th highest
> Adults who drink excessively: 17.6% — 21st lowest
> Premature mortality rate: 401 per 100,000 residents — 11th highest
> Median household income: $57,603 — 14th lowest

Source: f11photo / Getty Images

7. Louisiana
> Adults with cardiovascular disease: 10.2% — 7th highest
> Adults who’ve had heart attack: 4.5% — 13th highest
> Obesity rate: 35.4% — 4th highest
> Smoking rate: 23.1% — 3rd highest
> People who don’t exercise: 29.2% — 5th highest
> Adults who drink excessively: 19.6% — 19th highest
> Premature mortality rate: 454 per 100,000 residents — 7th highest
> Median household income: $51,073 — 4th lowest

Source: Davel5957 / Getty Images

7. Oklahoma
> Adults with cardiovascular disease: 10.2% — 7th highest
> Adults who’ve had heart attack: 4.9% — 7th highest
> Obesity rate: 33.7% — 7th highest
> Smoking rate: 20.1% — 12th highest
> People who don’t exercise: 29.3% — 4th highest
> Adults who drink excessively: 14.1% — 5th lowest
> Premature mortality rate: 458 per 100,000 residents — 6th highest
> Median household income: $54,449 — 8th lowest

Source: SeanPavonePhoto / Getty Images

6. Mississippi
> Adults with cardiovascular disease: 10.3% — 6th highest
> Adults who’ve had heart attack: 4.8% — 9th highest
> Obesity rate: 36.8% — the highest
> Smoking rate: 22.2% — 6th highest
> People who don’t exercise: 31.9% — the highest
> Adults who drink excessively: 13.6% — 3rd lowest
> Premature mortality rate: 500 per 100,000 residents — 2nd highest
> Median household income: $45,792 — the lowest

Source: Sean Pavone / Getty Images

4. Tennessee
> Adults with cardiovascular disease: 10.7% — 4th highest
> Adults who’ve had heart attack: 5.7% — 4th highest
> Obesity rate: 33.2% — 9th highest
> Smoking rate: 22.6% — 4th highest
> People who don’t exercise: 27.2% — 10th highest
> Adults who drink excessively: 14.3% — 6th lowest
> Premature mortality rate: 451 per 100,000 residents — 8th highest
> Median household income: $56,071 — 9th lowest

Source: Sean Pavone / Getty Images

4. Kentucky
> Adults with cardiovascular disease: 10.7% — 4th highest
> Adults who’ve had heart attack: 5.8% — 2nd highest
> Obesity rate: 33.8% — 6th highest
> Smoking rate: 24.6% — 2nd highest
> People who don’t exercise: 28.6% — 7th highest
> Adults who drink excessively: 17.3% — 17th lowest
> Premature mortality rate: 475 per 100,000 residents — 3rd highest
> Median household income: $52,295 — 7th lowest

Source: Sean Pavone / Getty Images

3. Alabama
> Adults with cardiovascular disease: 11.0% — 3rd highest
> Adults who’ve had heart attack: 5.2% — 5th highest
> Obesity rate: 35.5% — 3rd highest
> Smoking rate: 20.9% — 10th highest
> People who don’t exercise: 29.8% — 3rd highest
> Adults who drink excessively: 13.9% — 4th lowest
> Premature mortality rate: 475 per 100,000 residents — 4th highest
> Median household income: $51,734 — 5th lowest

Source: Davel5957 / Getty Images

2. Arkansas
> Adults with cardiovascular disease: 11.4% — 2nd highest
> Adults who’ve had heart attack: 5.8% — 2nd highest
> Obesity rate: 34.2% — 5th highest
> Smoking rate: 22.3% — 5th highest
> People who don’t exercise: 31.6% — 2nd highest
> Adults who drink excessively: 15.8% — 8th lowest
> Premature mortality rate: 460 per 100,000 residents — 5th highest
> Median household income: $48,952 — 3rd lowest

Source: Sean Pavone / Getty Images

1. West Virginia
> Adults with cardiovascular disease: 12.5% — the highest
> Adults who’ve had heart attack: 7.0% — the highest
> Obesity rate: 36.7% — 2nd highest
> Smoking rate: 26.0% — the highest
> People who don’t exercise: 28.9% — 6th highest
> Adults who drink excessively: 12.3% — 2nd lowest
> Premature mortality rate: 502 per 100,000 residents — the highest
> Median household income: $48,850 — 2nd lowest

Methodology

To determine the states with the most heart disease, 24/7 Tempo reviewed the share of residents 18 or older who ever had a major cardiovascular disease — including angina, coronary heart disease, a heart attack, or a stroke — as of 2018, the latest year for which data is available, with data from the U.S. Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. 

Also from the CDC BRFSS, we reviewed the share of adults who had coronary disease and at least one episode of heart attack as of 2018. Population and median household income figures are from the U.S. Census Bureau’s 2019 one-year American Community Survey.

Health outcomes and unhealthy behaviors such as obesity, smoking, physical inactivity, and age-adjusted premature mortality rate came from the 2020 County Health Rankings & Roadmaps, a joint program of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The premature mortality rate is defined as the number of deaths under the age of 75 per 100,000 people.

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