Health Mystery in New York:  Heart Disease

Death rates from heart disease in New York City and its suburbs are among the highest recorded in the country, and no one quite knows why.

The pattern has raised questions about whether people in the New York area live with an excess of heart disease risks – stress, bad diets, too little exercise. But it has also prompted speculation that doctors in the area may lump deaths with more subtle causes into the heart disease category, making that toll look worse than it actually is.

Now, there are efforts under way to sort out the mystery: The New York City health department and the National Institutes of Health are conducting extensive studies to better assess poorly measured factors like stress, blood pressure and cholesterol in people in the New York area.

But the phenomenon is only now drawing attention, as epidemiologists become more interested in geographic variation in disease.

The clearest predictors of heart disease are certain risky behaviors, like smoking and eating a high-fat diet. But according to the Centers for Disease Control’s Behavioral Risk Factor Surveillance System, an annual national survey, people in the New York area, whether the city or suburbs, smoke less than average and are less likely to be obese than those in the rest of the country. They may not get as much exercise, however, and they may also have higher cholesterol levels.

The discordant rates for stroke and heart disease in the New York area also lead some authorities to suggest that doctors and hospitals lump deaths from other causes into heart disease categories.

For complete article go to http://www.nytimes.com/2005/08/18/nyregion/18heart.html?th&emc=th.