The BBC's Fergus Walsh: The poorest men are 3 times more likely to die of a heart attack

It also says the UK is falling behind the rest of the developed world in combating the disease.

Heart disease is the UK's biggest killer and could over-run the health service in the coming decades, the report warns.

It says effective public health policy is essential if the disease is to be defeated.

Report author Professor Gerry Shaper: "It is fundamentally a nutritional problem"

But so far the UK is lagging behind the US and Australia in tackling the killer.

The report is published less than a week after another study found death rates from cancer were far higher among the poor.

Declining number of cases

The study, Looking To The Future: Making Coronary Heart Disease An Epidemic Of The Past, is published on Wednesday by the National Heart Forum (NHF).

It reviews the successes and failures of health policy in reducing incidence of the disease to date, and sets out what needs to be done in the future.

Professor Michael Marmot, who chaired the NHF group looking at social, political and economic factors, drew attention to the "widening social gradient in rates of coronary heart disease".

The study found that while the death rate from the disease has been halved among professional men there has been no reduction in deaths among people from the lower economic groups.

In the 1970s those from the working classes were 25% more likely to die from heart disease than professionals.

Now they are three times more likely to die from it.

"This widening gradient goes side by side with widening disparities in income - the sheer scale of which is alarming," Professor Marmot said.

"Tackling health inequalities needs to begin in childhood - and start by tackling deprivation and its effects in later life."

He said the way to achieve this was through education on nutrition and how doing well in life could safeguard health.

Living longer

The study also draws attention to the UK's ageing population. It says that by 2034 a quarter of the population will be above retirement age.

Professor Marmot said there is likely to be "a huge increase in the number of people suffering from coronary heart disease" when that happens.

The report said that heart disease could be toppled from its number one killer spot if current knowledge about how the disease works is turned into "effective policy action".

It found that incidence of the disease has declined in the UK by about 4% a year since the 1970s.

But this has not been as fast as rates in other countries.

And if health officials do not act, patients with heart disease will pack hospital wards, massively increasing the burden on the NHS budget.

Prevention and treatment

The review considers traditional and emerging risk factors for heart disease.

As well as the well-known risks - poor diet, smoking, and physical inactivity - the NHF group considered new causes such as infections and environmental pollutants.

Sir Sandy Macara: action today can stave off a future heart attack

However, Professor Gerry Shaper, who chaired the group, said: "The new evidence does not suggest that any dramatic changes should be made in the direction of current preventive changes.

"But what does emerge from international studies is that a population's susceptibility to heart disease is dependant on the average blood cholesterol levels in that population."

Overall, prevention should consist of a combination of lifestyle changes - improving diet, not drinking to excess or smoking and taking exercise - and drug treatments for those at higher risk.

Sir Sandy Macara, also a member of the group, told the BBC's Breakfast News that there was "every reason for hope" that the heart disease situation would improve "with the right policies".

Food manufacturers were lowering salt and fat content and promoting fruit and low-fat options, he said.

"Many people can limit their chances of a heart attack by doing the right thing now," he said.

Government action

The government is currently developing a national service framework for coronary heart disease.

This will set standards for treatment and prevention at a national level and will be enforced by the Commission for Health Improvement.

Public Health Minister Tessa Jowell said the report, which was partly funded by the Department of Health, would provide valuable guidance for tackling heart disease and shaping future services.

"Coronary heart disease is one of the key areas of the government's public health strategy," she said.