heart disease

CDC

It doesn't matter where you live in the United States; the leading cause of death is heart disease, followed closely by cancer.

But there are more than 113 causes of death listed in the The International Classification of Diseases, and any one of those can end up on someone's death certificate. 

That means there are a lot of state-by-state distinctions hidden in the bigger numbers.

Gabriela Camerotti / Flikr

Patients with heart disease should ask their doctors more questions before undergoing elective heart procedures.

That's according to a study by the Center for Healthcare Research and Transformation at the University of Michigan and Blue Cross/Blue Shield.
 
Marianne Udow-Phillips is Director of the Center and lead author of the study.   

She says whether or not Blue Cross/Blue Shield patients in the study underwent elective heart procedures depended more on where they received their care compared to whether or not it may have been the best option.

"We do believe that most of the use of these services is really more driven by physician preferences than patient preferences," said Udow-Phillips. "Patients do need to be more involved; they need to ask more questions of their physicians before they have a catheterization procedure.  There does need to be a better dialogue between physicians and patients."

The overall rate of these procedures have declined by 19-percent between 1997 and 2008.