The heart attack death rate in the Highland, Western Isles and Shetland council areas has gone up over the last decade, official data has shown.
The three local councils accounted for three of only four Scottish local authority areas to see an increase in heart attack mortality rate since 2008.
Highland saw the death rate go up by 7.3% from 74.9 deaths per 100,000 population to 80.4. Shetland saw a rise of 21.8% from 71.2 deaths per 1000,000 people to 86.7. And in the Western Isles the increase was 11.7%, from 106.3 deaths per 100,000 population to 118.7.
East Dunbartonshire was the only other council to see a rising death rate (3.5%). Everywhere else saw a decline between 2008 and 2017, according to the NHS Information Statistics Division (ISD) figures.
When 2017 figures were compared with the year before, there was a 47.4% increase in Highland. Over the smaller time span increases were also recorded in Aberdeen (28.1%, to 71.7 deaths per 100,000 people) and Aberdeenshire (17.5% to 70.8 deaths per 100,000).
But the overall trend was downward in Aberdeen and Aberdeenshire when 2017 figures were compared with 2008 statistics – minus 21.9% for Aberdeen and minus 18.9% for Aberdeenshire.
Scottish Conservative Highlands and Islands MSP Donald Cameron said: “These figures are a real cause for concern for people across the Highlands. We know from well-documented research that general physical wellbeing is far worse in other parts of the country than in the Highlands.
“So these figures suggest there is a serious problem with services. The SNP government is in sole charge of health in Scotland, and it needs to explain as a matter of urgency why these statistics are so bad for the area.”
The ISD figures for stroke were more encouraging in the Highlands with the mortality rate falling from 59 deaths per 100,000 population in 2008 to 44.6 in 2017, a drop of minus 24.4%
Every area in Scotland saw a fall in stroke death rate since 2008, apart from the Western Isles where it rose by 1.25 from 73.3 deaths per 100,000 population to 74.2.
An NHS Highland spokesman said: “The absolute number of deaths and the crude mortality rate reported in the ISD Heart Disease publication for 2017 for heart attacks is an increase in the Highland Council area. However, it is not clear from a single year of data whether this is anything more than an interruption to the overall downward trend in deaths from acute myocardial infarction (AMI) in Highland.”
A NHS Grampian spokesman said: “Although we do see some annual fluctuations in these figures, as is to be expected, the significant downward trend seen in both stroke and heart attack deaths over the last decade shows a much improved picture.”
A Scottish Government spokesman said: “Over the past decade the mortality rate for coronary heart disease has decreased by 36% and by 43% for stroke.”