I grew up in Memphis TN but lived in Boulder CO for a few years. I worked at a hospital in both cities; my job was checking people into the ER.

In Memphis, I’d probably see 7-10 heart related issues a day, with about 2-3 of them being actual heart attacks. Every single day.

By contrast, in Boulder I saw maybe 1-2 heart attacks a year.

It was absolutely astounding. Now, there could be some confounding variables like income/education/exercise/diet. But like another poster said, high altitude places seem to bring out more activity in us.

You have experience in 2 very different places demographically. High altitude may be on the list of factors but I would guess it’s pretty far down.

Boulder is a small college town of mostly affluent younger people. Memphis is an urban city in a hot climate that is older, poorer, and in the middle of the section of the US that has some of the worst health overall.

Boulder is one of the most fit places in the country. Lowest obesity rates, as you would expect from the first statement.