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Heart disease is the leading cause of death in the U.S.—here’s how it breaks down by state

A surprising number of factors make heart disease the leading cause of death in the United States. Yes, bad habits like smoking and routinely eating an unhealthy diet can lead to heart disease—but so can simply living longer.

Throughout the first half of the 20th century, doctors and scientists developed drugs and treatments for many diseases that once killed people younger, such as tuberculosis and pneumonia. And as people came to live longer, they simply had more time to develop the plaque in their arteries that leads to heart disease.

Although more than 75% of deaths from heart disease occur in low- and middle-income nations, America ranks #2 for deaths from heart disease among 17 peer countries. Public health campaigns across the country have aimed to educate Americans on the causes of heart disease, such as tobacco use, lack of exercise, and eating lots of foods high in cholesterol, while aiming to educate them on how to create habits for better heart health.

Citing 2020 and historical data from the CDC, ACLS Medical Training, a certification company for advanced cardiac life support training, compiled the death rates for heart disease across every state in the U.S., per 100,000 residents. ACLS also provided the mortality rates for three of the most common types of heart disease in the U.S.

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#50. Minnesota

Mortality rate per 100k, 2020: 118.1 (8,562 people, +8.0% increase since 2005)

• Congestive heart failure mortality rate per 100k: 12.6 (711 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 3.9 (221 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 8.7 (491 people)

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#49. Hawaii

Mortality rate per 100k, 2020: 125 (2,623 people, +13.1% increase since 2005)

• Congestive heart failure mortality rate per 100k: 11.2 (157 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 17.4 (245 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 23.1 (325 people)

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#48. Massachusetts

Mortality rate per 100k, 2020: 126.9 (11,781 people, -11.3% decrease since 2005)

• Congestive heart failure mortality rate per 100k: 20.8 (1,437 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 4.4 (302 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 15.9 (1,098 people)

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#47. Colorado

Mortality rate per 100k, 2020: 128.1 (8,023 people, +27.2% increase since 2005)

• Congestive heart failure mortality rate per 100k: 11.6 (675 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 10.2 (591 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 16.5 (958 people)

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#46. Oregon

Mortality rate per 100k, 2020: 134 (7,371 people, +8.5% increase since 2005)

• Congestive heart failure mortality rate per 100k: 15.4 (652 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 3.2 (136 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 5.9 (250 people)

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#45. Washington

Mortality rate per 100k, 2020: 134.6 (12,084 people, +10.0% increase since 2005)

• Congestive heart failure mortality rate per 100k: 5.4 (413 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 5.8 (450 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 14.5 (1,114 people)

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#44. Connecticut

Mortality rate per 100k, 2020: 138.4 (7,110 people, -7.1% decrease since 2005)

• Congestive heart failure mortality rate per 100k: 19.3 (687 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 8.7 (311 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 32.9 (1,169 people)

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#43. Alaska

Mortality rate per 100k, 2020: 139.8 (915 people, +45.9% increase since 2005)

• Congestive heart failure mortality rate per 100k: 6.2 (45 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 4.8 (35 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 28 (205 people)

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#42. Florida

Mortality rate per 100k, 2020: 143.1 (49,287 people, +6.5% increase since 2005)

• Congestive heart failure mortality rate per 100k: 15.2 (3,298 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 12.6 (2,737 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 25.6 (5,559 people)

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#41. Nebraska

Mortality rate per 100k, 2020: 143.8 (3,532 people, -3.0% decrease since 2005)

• Congestive heart failure mortality rate per 100k: 19.5 (377 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 3 (58 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 5.2 (100 people)

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#40. California

Mortality rate per 100k, 2020: 144 (66,538 people, +2.5% increase since 2005)

• Congestive heart failure mortality rate per 100k: 18.5 (7,298 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 8.6 (3,394 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 21.6 (8,516 people)

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#39. Arizona

Mortality rate per 100k, 2020: 144.8 (14,196 people, +29.5% increase since 2005)

• Congestive heart failure mortality rate per 100k: 8 (594 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 11.4 (848 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 23.5 (1,742 people)

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#38. Maine

Mortality rate per 100k, 2020: 146.2 (3,035 people, +3.2% increase since 2005)

• Congestive heart failure mortality rate per 100k: 10.5 (142 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 11.9 (160 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 9.5 (128 people)

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#37. New Hampshire

Mortality rate per 100k, 2020: 146.5 (2,814 people, +11.2% increase since 2005)

• Congestive heart failure mortality rate per 100k: 23.7 (324 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 7 (95 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 26.2 (358 people)

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#36. North Dakota

Mortality rate per 100k, 2020: 147.3 (1,449 people, -4.2% decrease since 2005)

• Congestive heart failure mortality rate per 100k: 18.2 (139 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 3.4 (26 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 16.1 (123 people)

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#35. Rhode Island

Mortality rate per 100k, 2020: 150.5 (2,319 people, -22.8% decrease since 2005)

• Congestive heart failure mortality rate per 100k: 19.4 (205 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 14.3 (151 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 38.2 (404 people)

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#34. Idaho

Mortality rate per 100k, 2020: 151.9 (3,191 people, +30.2% increase since 2005)

• Congestive heart failure mortality rate per 100k: 18.2 (333 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 3.9 (72 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 5.7 (105 people)

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#33. Virginia

Mortality rate per 100k, 2020: 152 (15,678 people, +10.5% increase since 2005)

• Congestive heart failure mortality rate per 100k: 21.8 (1,875 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 6 (519 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 13.5 (1,158 people)

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#32. New Mexico

Mortality rate per 100k, 2020: 152.7 (4,219 people, +22.8% increase since 2005)

• Congestive heart failure mortality rate per 100k: 14.4 (303 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 3.7 (77 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 56 (1,180 people)

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#31. South Dakota

Mortality rate per 100k, 2020: 155.2 (1,820 people, +2.5% increase since 2005)

• Congestive heart failure mortality rate per 100k: 6.9 (62 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 8.4 (75 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 8.4 (75 people)

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#30. Utah

Mortality rate per 100k, 2020: 155.6 (4,251 people, +48.0% increase since 2005)

• Congestive heart failure mortality rate per 100k: 24.5 (796 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 4.9 (158 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 13.3 (433 people)

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#29. North Carolina

Mortality rate per 100k, 2020: 156.2 (20,373 people, +14.7% increase since 2005)

• Congestive heart failure mortality rate per 100k: 24.3 (2,576 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 6.4 (680 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 16.5 (1,749 people)

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#28. Delaware

Mortality rate per 100k, 2020: 159.6 (2,171 people, +6.9% increase since 2005)

• Congestive heart failure mortality rate per 100k: 22.7 (224 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 11.2 (111 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 31.9 (315 people)

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#27. Wyoming

Mortality rate per 100k, 2020: 160.4 (1,174 people, +23.3% increase since 2005)

• Congestive heart failure mortality rate per 100k: 22.8 (133 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 12.4 (72 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 22 (128 people)

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#26. Wisconsin

Mortality rate per 100k, 2020: 162.2 (12,641 people, +6.7% increase since 2005)

• Congestive heart failure mortality rate per 100k: 23 (1,343 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 7.4 (432 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 23.1 (1,350 people)

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#25. Montana

Mortality rate per 100k, 2020: 162.7 (2,424 people, +30.7% increase since 2005)

• Congestive heart failure mortality rate per 100k: 22.8 (246 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 8.4 (91 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 59.8 (646 people)

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#24. New Jersey

Mortality rate per 100k, 2020: 166.3 (19,744 people, -4.4% decrease since 2005)

• Congestive heart failure mortality rate per 100k: 22.4 (1,986 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 10 (889 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 24.4 (2,171 people)

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#23. Kansas

Mortality rate per 100k, 2020: 167 (6,264 people, +5.1% increase since 2005)

• Congestive heart failure mortality rate per 100k: 18.6 (543 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 6.8 (199 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 17.3 (505 people)

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#22. Vermont

Mortality rate per 100k, 2020: 167.1 (1,521 people, +23.3% increase since 2005)

• Congestive heart failure mortality rate per 100k: 7.1 (44 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 8.7 (54 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 88.6 (552 people)

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#21. Maryland

Mortality rate per 100k, 2020: 168.3 (12,624 people, +8.9% increase since 2005)

• Congestive heart failure mortality rate per 100k: 11 (669 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 19.2 (1,162 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 39 (2,359 people)

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#20. South Carolina

Mortality rate per 100k, 2020: 170.9 (11,385 people, +21.6% increase since 2005)

• Congestive heart failure mortality rate per 100k: 19.8 (1,031 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 9.8 (511 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 18 (941 people)

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#19. Illinois

Mortality rate per 100k, 2020: 171.4 (27,460 people, -2.7% decrease since 2005)

• Congestive heart failure mortality rate per 100k: 28.2 (3,547 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 12.8 (1,617 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 8.5 (1,071 people)

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#18. Iowa

Mortality rate per 100k, 2020: 172.9 (7,499 people, +.8% increase since 2005)

• Congestive heart failure mortality rate per 100k: 16.7 (529 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 6.8 (214 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 37.8 (1,197 people)

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#17. Texas

Mortality rate per 100k, 2020: 173.9 (50,281 people, +25.2% increase since 2005)

• Congestive heart failure mortality rate per 100k: 14.5 (4,265 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 11.4 (3,361 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 23.6 (6,922 people)

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#16. Pennsylvania

Mortality rate per 100k, 2020: 175.7 (32,936 people, -9.0% decrease since 2005)

• Congestive heart failure mortality rate per 100k: 29 (3,708 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 9.5 (1,216 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 28.1 (3,591 people)

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#15. Georgia

Mortality rate per 100k, 2020: 183.7 (21,116 people, +25.8% increase since 2005)

• Congestive heart failure mortality rate per 100k: 24 (2,572 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 20.8 (2,225 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 8.3 (888 people)

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#14. New York

Mortality rate per 100k, 2020: 183.9 (48,546 people, -6.6% decrease since 2005)

• Congestive heart failure mortality rate per 100k: 9 (1,739 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 18.7 (3,621 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 37.4 (7,224 people)

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#13. Indiana

Mortality rate per 100k, 2020: 183.9 (15,169 people, +4.3% increase since 2005)

• Congestive heart failure mortality rate per 100k: 22.6 (1,524 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 10.3 (699 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 10.1 (679 people)

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#12. Missouri

Mortality rate per 100k, 2020: 196.7 (15,934 people, +6.4% increase since 2005)

• Congestive heart failure mortality rate per 100k: 30.1 (1,852 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 12.2 (751 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 16.5 (1,016 people)

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#11. Ohio

Mortality rate per 100k, 2020: 196.9 (30,547 people, +5.3% increase since 2005)

• Congestive heart failure mortality rate per 100k: 22.7 (2,652 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 11.8 (1,374 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 24.7 (2,886 people)

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#10. West Virginia

Mortality rate per 100k, 2020: 197.8 (5,123 people, -7.5% decrease since 2005)

• Congestive heart failure mortality rate per 100k: 22.5 (402 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 18.4 (328 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 31.2 (556 people)

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#9. Nevada

Mortality rate per 100k, 2020: 201.3 (7,285 people, +43.0% increase since 2005)

• Congestive heart failure mortality rate per 100k: 12.7 (399 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 20.9 (657 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 56.7 (1,778 people)

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#8. Kentucky

Mortality rate per 100k, 2020: 204.5 (11,345 people, +5.2% increase since 2005)

• Congestive heart failure mortality rate per 100k: 27.1 (1,213 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 17.2 (772 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 14.8 (662 people)

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#7. Michigan

Mortality rate per 100k, 2020: 205 (27,127 people, +8.0% increase since 2005)

• Congestive heart failure mortality rate per 100k: 26.3 (2,623 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 20.6 (2,050 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 44.5 (4,436 people)

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#6. Tennessee

Mortality rate per 100k, 2020: 212 (17,943 people, +20.1% increase since 2005)

• Congestive heart failure mortality rate per 100k: 15.3 (1,054 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 17.8 (1,228 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 31.3 (2,155 people)

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#5. Louisiana

Mortality rate per 100k, 2020: 221.5 (12,255 people, +11.3% increase since 2005)

• Congestive heart failure mortality rate per 100k: 37 (1,721 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 19.7 (913 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 34.7 (1,610 people)

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#4. Arkansas

Mortality rate per 100k, 2020: 222.5 (8,621 people, +13.8% increase since 2005)

• Congestive heart failure mortality rate per 100k: 26.1 (791 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 22.1 (669 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 13.4 (406 people)

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#3. Alabama

Mortality rate per 100k, 2020: 237.5 (14,739 people, +14.5% increase since 2005)

• Congestive heart failure mortality rate per 100k: 40.8 (2,009 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 13.6 (667 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 21.5 (1,058 people)

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#2. Oklahoma

Mortality rate per 100k, 2020: 244.1 (11,758 people, +17.1% increase since 2005)

• Congestive heart failure mortality rate per 100k: 18 (717 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 59.1 (2,354 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 53.3 (2,123 people)

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#1. Mississippi

Mortality rate per 100k, 2020: 245.6 (8,809 people, +2.0% increase since 2005)

• Congestive heart failure mortality rate per 100k: 44.3 (1,315 people)
• Hypertensive heart disease (without congestive heart failure) mortality rate per 100k: 26 (771 people)
• Atherosclerotic cardiovascular disease mortality rate per 100k: 8.4 (248 people)