City Dwellers May Get More Heart Disease

Contrary to previous findings, a new study shows that where you live plays a bigger role in your risk for heart disease than your ethnicity or race.

"We found that urban Caucasians had risk factors that were more similar to those of urban African-Americans than rural Caucasians," says researcher Carol Homko, Ph.D., assistant professor at Temple University School of Medicine in Philadelphia.

The study showed that based on blood pressure and cholesterol levels, smoking status, age, sex, and diabetes, urban dwellers had a greater risk of developing heart disease over the next 10 years: 18 percent vs. 16 percent for rural residents.

Further analysis showed that urban residents of either race were more likely to smoke: 43 percent vs. 13 percent of rural residents, and more suffered from diabetes: 55 percent vs. 37 percent.

The urban dwellers also had larger waistlines and higher levels of an inflammatory blood marker known as C-reactive protein that has been linked to an increased risk of heart disease.

Interestingly, rural residents of both races were more knowledgeable about healthy eating and heart disease risks than their urban counterparts, Homko says.

For the study, the researchers tracked the habits of 254 rural residents, nearly all of whom were white, and 211 inner-city dwellers, 28 of whom were white.

Previous studies have shown that the difference in heart disease risk among urban and rural residents could be explained by differences in racial makeup, but these findings challenge that view, she says.

The findings were presented here at the annual meeting of the American College of Cardiology.

Lifestyle to Blame

Homko says the differences are largely due to lifestyle.

"It's much harder to exercise in the city because of safety issues," she tells WebMD. "And it's more difficult to find reasonably priced fresh fruits and vegetables."

Sidney Smith, M.D., director of the center for cardiovascular science and medicine at the University of North Carolina at Chapel Hill and a past president of the American Heart Association, says the findings are consistent with global trends.

"As populations become more urbanized, we're seeing an increase in heart disease risk factors and rates," he tells WebMD.

Smith agrees a lack of exercise and less-healthy eating habits are to blame. His advice to urbanites: "Don't let go of the values you had when you lived in rural areas. Look for new ways to exercise, such as taking the stairs and walking to work. And eat your fruits and vegetables."

By Charlene Laino
Reviewed by Louise Chang, M.D.
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