ATLANTA (AP) – West Virginia and Kentucky – states known for high levels of obesity, diabetes and smoking – have the highest proportion of people with heart disease in the nation, U.S. health officials said Thursday.

The findings, from the first study ever to look at heart disease prevalence state by state, showed that states in the Southeast and Southwest were heart disease leaders. Colorado and the District of Columbia had the lowest percentages.

The results line up well with previous, state-specific 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 report by the U.S. Centers for Disease Control and Prevention “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.

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.

Participants were asked if a doctor or health care professional had told them they had experienced a heart attack, angina, or coronary heart disease.

The researchers then statistically adjusted the results to correct demographic differences in state samples to better mirror the U.S. census.

The prevalence in both Colorado and the District of Columbia was a little under 5 percent, tying them for the nation’s lowest rate. Hawaii was close behind.

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, said the study’s lead author, Jonathan Neyer, a CDC epidemiologist.

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 findinAmong those who didn’t finish high school, 1 in 10 had at least one of the conditions. Among college graduates, only 1 in 20 did.

– More than 8 percent of men had one of the conditions, but only 5 percent of women did.

– Nearly 1 in 5 people 65 and older had at least one of the conditions. The percentages were much smaller among younger age groups.

– The results were the same for blacks and whites, with just over 6 percent having one of the conditions. Fewer than 5 percent of Asian-Americans had any of the health problems, making them the healthiest ethnic group. American Indians and Alaska Natives had the highest prevalence, at about 11 percent.

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