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Rivers, Heart Disease May Be Linked

April 15, 1998

FRANKFORT, Ky. (AP) _ Nine states that lie along the Mississippi and Ohio rivers have something lethal in common.

Their death rates from heart disease are among the highest in the nation.

Why? ``I think we don’t have a clue,″ Dr. Glenn Caldwell, Kentucky’s state epidemiologist, said Tuesday.

But the pattern is intriguing enough that health experts from around the country are coming to Kentucky for a conference Thursday and Friday on the mystery of ``Coronary Valley.″

Dr. James Muller, who arranged the symposium, discerned the pattern after arriving from Harvard to become director of Gill Heart Institute at the University of Kentucky in 1996.

It was no secret that Kentucky had a high death rate from heart disease _ 116.7 deaths per 100,000 people, fifth highest in the nation.

But in looking at maps of the distribution of heart disease, ``I noticed that it seemed to go down the Ohio River and down the Mississippi, so I started calling it the Coronary Valley,″ Muller said.

Caldwell said Coronary Valley likely can be explained by a combination of lifestyle, genetic and environmental factors.

Other states that border the two rivers and rank in the top 12 for deaths from heart disease are Missouri, Arkansas, West Virginia, Indiana, Tennessee, Louisiana, Ohio and Illinois.

``I would be very wary ... of saying the river did it,″ Caldwell said. ``It’s eye-catching, but I’m not at all sure it has any biological meaning.″

In fact, Minnesota, where the Mississippi rises, has one of the lowest rates at 81.4 deaths per 100,000 people, according to the National Center for Health Statistics in Hyattsville, Md.

Wisconsin and Iowa, also on the Mississippi, fall between the two extremes.

New York, split by the Hudson River, has the nation’s highest rate at 135.9 and Oklahoma is second at 120.2. The remaining state in the top dozen is Michigan, 11th at 108.4.

New Mexico reports the fewest deaths from heart disease, 54.2 per 100,000. Yet, like Kentucky, it has high rates of obesity and diabetes, two of the most notorious risk factors for heart disease, a researcher says.

Dr. Johnathan Abrams, a University of New Mexico cardiologist who will speak at the upcoming conference, said genetics might be a factor.

Indigenous Hispanics and American Indians, who together make up about half the state’s population, traditionally have extremely low rates of heart disease, he said.

But, ``we have more diabetes, more obesity in our Hispanic and native populations by far _ two- to threefold the rates. Now, that should increase coronary disease,″ Abrams said. ``I’m not going to have an answer. I’m going to suggest tongue-in-cheek that it’s green chili.″

Muller said the conference will examine obvious risk factors for heart disease _ smoking, sedentary lifestyle, hypertension, diabetes, elevated cholesterol _ and whether they account for differences between states.

Other possible factors include genetics, infections, allergies and water, including pollutants and minerals.

``If we find that the known risk factors for New Mexico are identical to the known risk factors for Kentucky, yet Kentucky’s death rate is twice that, then we have some unknown process going on,″ he said.

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