Deaths due to heart disease in England are most common in the North West, primary care trust figures indicate.
The mortality rate in one PCT, Tameside and Glossop, is almost four times that of Kensington and Chelsea in London.
Three of the five worst death rates are found in the North West, while the South has the lowest rates of deaths through coronary heart disease.
The charity Heart UK used 2009 figures released by the NHS Information Centre to compile the report.
Among the areas with the highest deaths through coronary heart disease are Blackburn with Darwen PCT, Leicester City PCT and Manchester PCT.
Some of the lowest rates of death through heart disease are found in Westminster PCT, East Sussex Downs and Weald PCT, Dorset PCT and Surrey PCT.
But within some of the big cities, the picture is more complicated than a simple North-South divide.
Kensington and Chelsea has extremely low rates of heart deaths – 36.91 people out of every 100,000.
Just a few miles away, Islington City PCT has rates three times higher at 114.12 out of every 100,000 people.
Heart UK chief executive Jules Payne said no matter where they lived, people could reduce their risk of having a heart attack or stroke through being aware of the risk factors.
“There are simple changes that people can make to improve their heart health.
“Those diagnosed with heart problems should take a proactive approach towards their health – knowing their cholesterol and blood pressure numbers and weight, going for regular check-ups and speaking to their doctor if they have any concerns.
“For those with a family history of heart disease, small changes to diet and lifestyle for example can help reduce the risk of cardiovascular disease.”
The wide geographical variation across England highlighted by the report confirms other studies that have revealed a North-South divide on health.
Dr Jessica Allen, of University College London, is one of the authors of a landmark report on health inequalities in England, the Marmot Review.
“Significant variations in risk of suffering heart disease across England are shocking but sadly not unexpected,” she said.
“We know that many health conditions relate to social and economic status and these largely explain the variations in life expectancy and health status that we see across England between regions and within smaller areas.
“It is still the case in England, as in most other countries, that the richer you are the healthier you are likely to be and the longer you will live.”
Heart Research UK lifestyle manager Barbara Dinsdale said: “Geographical health inequalities exist throughout the UK, which means that the incidence of heart disease varies regionally.
“People living in deprived communities, in particular, are at greater risk of developing heart disease due to several risk factors such as poor diet, lack of exercise and access to health education and advice.”
Heart UK is launching a ‘hotspots’ campaign to raise awareness of the inequalities across England and encourage patients to look after their health.