ATLANTA — Hawai'i has one of the lowest rates of heart disease in the nation, U.S. health officials said yesterday.

Several of the states with the highest heart disease rates lie in a swath of Southeastern states known for high-fat diets.

West Virginia and Kentucky — states known for high levels of obesity, diabetes and smoking — have the highest proportion of people with heart disease, according to a new report by the U.S. Centers for Disease Control and Prevention.

States reporting the lowest heart disease rates lie mainly in the West and Midwest: Colorado, Montana, Nebraska, New Mexico, Utah, Wisconsin and Wyoming.

Colorado and the District of Columbia had the nation's lowest rate, at 4.8 percent, followed by Hawai'i with the third-lowest rate. In Hawai'i, only 4.9 percent of people have had a heart attack, chest pain or narrowed arteries, according to the CDC.

In West Virginia, more than 10 percent of the population have had such conditions.

Asian-Americans were the healthiest ethnic group nationwide, at 4.7 percent.

The results were the same for blacks and whites, with just over 6 percent having one of the conditions. American Indians and Alaska Natives had the highest prevalence, at about 11 percent.

The state-by-state results line up well with previous reports about heart disease death rates, obesity and other risk factors, said Wayne Rosamond, an epidemiology professor at the University of North Carolina who chairs a statistics committee for the American Heart Association.

He called the CDC's report "very important. It confirms what we know about regional differences in the burden of disease."

For the nation as a whole, roughly 4 percent of those surveyed had had a heart attack. A slightly higher percentage reported angina or coronary heart disease, and 6.5 reported any of those conditions.

But in West Virginia, more than 10 percent had at least one of the conditions. The prevalence in Kentucky was nearly 9 percent and Mississippi was No. 3 with 8 percent.

$151 BILLION BURDEN

Heart disease has been the nation's biggest killer for nearly a century and could cost the economy $151 billion this year for medical care, lost productivity and other direct and indirect costs. Yet doctors have lacked reliable state-by-state information to enable them to determine where to target prevention programs.

The new study provides that data, filling the gap between surveys showing how many people suffer from heart disease risk factors and how many people die of heart disease, said the study's lead author, Jonathan Neyer of the CDC's division for heart disease and stroke prevention.

The new survey, he said, supplies the estimated prevalence of people "actually living with heart disease."

VAST SURVEY

CDC researchers drew their data from a 2005 telephone survey of 356,112 U.S. adults in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands. The analysis is in today's "Morbidity and Mortality Weekly Report."

Participants were asked if a doctor or healthcare professional had told them they had experienced a heart attack, angina or coronary heart disease. The researchers then adjusted the results to correct demographic differences in state samples to better mirror the U.S. census.

The regional differences are believed to stem from rates of obesity, high blood pressure, high cholesterol, diabetes, smoking and other known risk factors for heart disease, Neyer said.

That means the explanation would come from differences in cultural norms, poverty rates and other social factors, and not environmental causes, he said. "There's not something in the water," Neyer said.

Other findings: