Background: Heart disease is among the leading causes of death in the U.S. and Canada. Despite the U.S.'s higher spending on health care, it is unclear whether persons with heart disease fare better in one country or the other.Methods: To evaluate and compare the health of people aged 45 and older in the U.S. and Canada, we drew upon the Joint Canada-U.S. Survey of Health (JCUSH), a random telephone interview conducted from 2002 to 2003. We used self-reported fair or poor health, disability, and functional impairment as dependent variables in logistic regressions, which controlled for demographic variables and other risk factors.Results: Adjusting for covariates, Canadian respondents with heart disease reported better health as measured by disability, but there was no difference for functional impairment or self-reported fair or poor health. The odds ratios (Canada:U.S.) were 1.10 (p=0.69) for fair or poor health, 0.56 (p=0.06) for disability, and 0.78 (p=0.32) for functional impairment.Conclusions: Our results indicate that people with heart disease are in better health in Canada as measured by disability, but there is no difference for overall self-reported health or functional impairment. Further research must be done to determine the cause of outcomes differences among heart disease patients.