A major new analysis has revealed America's heart disease hotspots, with Southern states recording dramatically higher death rates than the rest of the country. The study, conducted by healthcare company NiceRx using data from the CDC, found that Oklahoma has the highest rate of heart disease deaths in the United States, while Minnesota has the lowest.
National Statistics
Heart disease kills nearly 700,000 Americans every year, equating to one person every 34 seconds, making it the nation's leading cause of death. Nationally, there are 201 deaths from heart disease per 100,000 people annually. However, in Oklahoma, the worst-hit state, the death rate rises to 251 per 100,000 people, almost 25 per cent above the national average.
Regional Disparities
Seven of the ten states with the highest death rates were in the South, including Mississippi, Alabama, Arkansas, Louisiana, Tennessee, and West Virginia. At the opposite end of the scale, states in the Western half of the country generally recorded the lowest rates. Minnesota had the lowest heart disease death rate in the US, with 120 deaths per 100,000 people, followed by Hawaii and Colorado.
Underlying Causes
Heart disease is a broad term covering several conditions affecting the heart. The most common is coronary artery disease, where fatty deposits build up inside blood vessels supplying the heart, restricting blood flow and increasing the risk of heart attacks and strokes. Experts said the divide in heart disease deaths broadly mirrors obesity rates across America. States with higher obesity levels also tend to record higher rates of high blood pressure, high cholesterol, and type 2 diabetes, all major risk factors for heart disease.
Rob Stransky, president of NiceRx, commented: 'Heart disease continues to place a major burden on the United States, but this data shows that the impact is not evenly spread. Carrying excess weight raises the risk of high blood pressure, high cholesterol, and type 2 diabetes, all of which place added strain on the heart. Over time, this can significantly raise the risk of serious complications such as heart attacks and strokes.'
Lifestyle and Healthcare Factors
Experts also pointed to wider lifestyle and healthcare differences between regions. People in Southern states are generally more likely to consume fried and fast foods, increasing obesity risk, while also being less likely to have health insurance, making heart disease less likely to be diagnosed and treated early. By contrast, people living in more health-conscious Western states tend to eat more whole and minimally processed foods, exercise more frequently, and have better healthcare coverage.
Top and Bottom States
Rounding out the five states with the highest heart disease death rates were Mississippi, Alabama, Arkansas, and Louisiana, each recording at least 217 heart disease deaths per 100,000 people every year. Meanwhile, Massachusetts and Connecticut joined Minnesota among the states with the lowest rates, recording 129 and 130 deaths per 100,000 people respectively.
Researchers said it was not entirely clear why Oklahoma had the highest heart disease death rate in the country. The state has the 14th highest obesity rate nationwide and the third highest proportion of residents without health insurance. It was also unclear why Minnesota performed so well, although experts said this may be linked to higher healthcare coverage and lower obesity and smoking rates. The state has the 15th lowest obesity rate in the US.
Trends Over the Past Decade
The report also examined how heart disease death rates have changed over the past decade by comparing 2023 figures with those from ten years earlier. New Mexico recorded the sharpest rise, with heart disease deaths increasing by 13.7 per cent over the decade despite the state ranking only 21st overall for deaths. Iowa saw the second fastest rise at 12.1 per cent, followed by Nebraska at 11 per cent. In contrast, 28 states recorded declines in heart disease deaths over the same period. New York saw the steepest fall, with death rates dropping by 14.3 per cent, followed by New Jersey at 12.1 per cent and Connecticut at 10.9 per cent.
New Mexico has also recorded the fastest rise in obesity rates over the past decade, with obesity increasing by 33.7 per cent. Meanwhile, in the tri-state area covering New York, New Jersey, and Connecticut, obesity rates stopped rising in 2024, according to the latest data.
Stransky added: 'Losing weight is not always straightforward, particularly for people who have struggled for years to manage their weight through diet and exercise alone. Sustainable lifestyle changes remain the foundation, including eating a balanced diet, staying active, reducing processed foods and improving sleep. For some people, medically-guided weight loss support can also play an important role.'
