If a high-fat cholesterol-laden snack doesn’t trigger a heart attack, then a healthy economy just might.

The risk of a fatal heart attack rises when the U.S. economy strengthens and increases further if macroeconomic conditions remain robust over the next several years, according to a study published last month.

The death rate rises in the year the economy expands and grows further if the lower rate of joblessness is maintained, Christopher Ruhm wrote in his study.

A 1-percentage point drop in unemployment is estimated to raise mortality by 1.3 percent or 2,515 additional deaths per year from heart attacks, the study showed. The mortality rate is similar for males and females.

The 20-44 age group is at a relatively higher risk than older persons, especially if the economic upturn is sustained.

Ruhm, an economics professor at the University of North Carolina at Greensboro, used the example of a six-month stint working in another city for what that individual sees as a great opportunity.

“During that period of time chances are you are working so much you are not exercising, haven’t had a chance to join a gym, you’re eating out a lot, maybe smoking more,” Ruhm said by phone from North Carolina.

“When the economy heats up, people often end up working more overtime,” Ruhm said, adding they might let other parts of their life go by the wayside for a while including health.

The study focuses on 20 states with the largest populations pooled over the years 1979 to 1998 including California, New York, Texas, Florida, Pennsylvania, Illinois, Ohio, Michigan, New Jersey, North Carolina, Georgia, Virginia, Massachusetts, Indiana, Missouri, Tennessee, Wisconsin, Washington state, Maryland and Minnesota.

These states account for almost three-quarters of the national heart attack death rate and have similar patterns to the entire country.