STATEN ISLAND, N.Y. -- Staten Island had the highest rates of women and men dying from heart disease in all five boroughs, according to an industry research analysis of recent data.

While the death rates are decreasing, the Island is seeing the smallest decline.

The number of Staten Island women dying from heart disease per 100,000 residents was 216.2 from 2013 to 2015, a 13.6 percent drop from the 250.2 death rate between 2009 and 2011.

The number of borough men dying from heart disease per 100,000 residents was 284.3 per 100,000 residents, a 15 percent drop from the 334.7 death rate between 2009 and 2011.

The citywide death rate for women was 162.4 per 100,000 residents between 2013 and 2015, compared to 238.5 for men.

These numbers from the Centers for Disease Control and Prevention were compiled as part of the Pharmaceutical Research and Manufacturers of America's statewide "GOBOLDLY" campaign, which aims to educate New Yorkers about advances in science.

POTENTIAL DRIVERS

The reason for the borough's high rates are likely related to lifestyle, according to Dr. Mohammed Imam, who chairs cardiothoracic surgery at Staten Island University Hospital and heads the Heart Institute in NYC.

"Why specifically Staten Island? I don't know for sure," Imam said. "Heart disease is usually directly related to your habits. The dietary habits on Staten Island, you aren't going to find them in Manhattan."

Smoking tobacco, cholesterol levels, high blood pressure, physical inactivity, obesity, uncontrolled diabetes and uncontrolled stress and anger are the controllable risk factors, according to the American Heart Association. Genes can also increase the risk for heart disease.

"Your genes always load the gun but your habits pull the trigger," Imam said.

Dr. Richard Grodman, chair of cardiology at Richmond University Medical Center, said that any explanation for the borough's high rates would be theoretical, but noted a "sedentary lifestyle" could also be to blame.

Grodman was asked if Staten Island's reliance on cars -- 80 percent of borough households have at least one -- was then also a factor.

"I couldn't say no to that," Grodman said. "But I think it's more important what they do when they get home from work."

SMOKING, OBESITY RATES

About 610,000 people die of heart disease in the United States each year, or one in every four deaths, according to the Centers for Disease Control.

Heart disease is the number one cause of death citywide and in all three community districts, according to the latest community profiles from the city's Health Department. The North Shore had the highest death rate.

Grodman said that this is likely the case because of "poverty and lack of education on the North Shore." He said RUMC often has problems getting patients to comply with doctors orders after leaving the hospital, sometimes because they can't afford to do so.

Twenty percent of Staten Island adults also said they were current smokers, according to the city's most recent health surveys. The North Shore had the highest rate among community districts citywide with 22 percent of residents saying they currently smoke.

"If I had to guess number one would be smoking," Grodman said when asked why Staten Island has higher heart disease death rates than outside the borough.

Twenty-nine percent of Staten Island adults reported that they were obese and 10 percent said they had diabetes, according to that latest survey, which was conducted from 2011 to 2013.

'AWARENESS IS LACKING'

"Staten islanders may like to to think its pollution from New Jersey but we don't have any data showing that," Grodman said. "I think the community has to be more well informed."

Grodman and Imam said Staten Islanders should assess their risks for heart disease. They recommend watching your weight, go to the doctor for regular checkups, quit smoking, exercise moderately every day if possible and eat better.

"Eighty percent of a heart healthy lifestyle is in the kitchen," Imam said, explaining that Islanders shouldn't simply exercise while also eating poorly.

"We need more community programs here to educate people," Imam added. "A sense of awareness is lacking."