But in terms of how they fare when they get to hospital, their quality of care appears to be about the same, says the report released Thursday by the Canadian Institute for Health Information.
"This is data to support providing specific strategies to help at-risk and disadvantaged populations," said Toronto cardiologist Dr. Beth Abramson, a spokesperson for the Heart and Stroke Foundation.
"Canadians can't rely on a good in-hospital health-care system to prevent the heart disease in the first place ... I think we'll be misled if we think that equal access to health care means equal access to good health."
Almost 67,000 Canadians landed in hospital due to a heart attack in 2008-09.
A breakdown of five neighbourhood income levels found that those in the least-affluent areas were 37 per cent more likely to have a heart attack than those in the most-affluent districts.
The report says the risk of dying in hospital within 30 days was about the same for all socio-economic groups, averaging 8.3 per cent. However the most affluent patients were seven per cent more likely than the least affluent to have a procedure such as angioplasty or bypass surgery.
"Medical literature indicates that not every patient is selected for or would benefit from such a procedure," the report said.
Heart attack rates were at a high of 347 per 100,000 in Newfoundland and Labrador and a low of 169 per 100,000 in British Columbia, after population age differences were taken into account.
"B.C., who seems to be doing relatively well, has had its prevention strategy ... for many years, and that may help explain some of the differences we're seeing," Abramson noted.
The CIHI researchers said that addressing gaps in heart health between socio-economic groups and geographic areas in Canada could help improve the health of the population.
The Health Indicators 2010 report included an estimate of cost savings if all socio-economic groups had a heart-attack rate like that of the most affluent neighbourhoods.
"The overall rate of hospitalized heart attacks would have decreased by approximately 16 per cent, or the equivalent of about 10,400 hospitalized heart attacks," the report said.
"Based on 2007-2008 cost data, this represents an estimated potential savings in hospital costs of about $100 million, not including physician fees."
Abramson said individuals should make personal changes by trying to be more physically active and eat a healthy diet.
"Sometimes patients with higher socio-economic status tend to be proactive about their health and well enough educated to be able to ask the right questions," she said.
"And we certainly need to be advocates for all Canadians' health, regardless of their income or educational status."