But Dr Evans, of Launceston Heart Centre, said he had that conversation far too often in Tasmania, where heart disease claims people young, and often.

Research released by The Heart Foundation this week showed that Tasmania had the highest rate of cardiovascular disease in the country, with one in four people affected.

Dr Evans said he was shocked by the frequency and severity of heart disease when he returned to the state after a 15-year stint on the mainland.

"I'm just sick of seeing 32-year-olds who walk in obese, and they're diabetics with high blood pressure and they have a terrible diet. They do nothing," Dr Evans said.

"They come in with chest pain, and I know that their history is already written for them - they're not going to survive much longer, and there's nothing you can do.

"It's extremely disappointing, and I'd say that despite lots of money being spent on public infrastructure, things are actually probably worse."

Dr Evans said the situation was particularly bad on the North-West Coast, where a lot of people died before they reached the age of 50.

He said this was partly due to the genetics, with the region's Anglo population susceptible to high blood pressure and cholesterol.

But he said poor education, a lack of exercise and poor eating habits, alcohol and smoking also contributed.

"I remember seeing a young man . . . at the Mersey, about three years ago, who had a cholesterol of eight, which is just disastrous," Dr Evans said.

"Type 2 diabetic, hypertensive, smoker, sleep apnoea, and he came in with chest pain, and he didn't actually make it to get his angiogram."

Dr Evans said that high blood pressure and high cholesterol were often without symptoms, and a lot of Tasmanians died without seeing a doctor.

He said he wanted to see a decent primary health prevention program introduced in schools, which would see students learn more about healthy eating and a healthy lifestyle.

"They just need to be pummeled with it so by the time they leave secondary school it's so deeply ensconced in them they know what to do," Dr Evans said.

"The exciting thing is the North-West has a very restricted population . . . so if you start to put a program in place like that, you can very quickly see if you're getting value for money."

Health Minister Michael Ferguson said a whole-of-community response was needed.

"While there is not one single answer to this challenge, improving nutrition and physical activity for the whole community is the key," Mr Ferguson said.

He said the state government would take a "statewide integrated approach" to making Tasmania the healthiest population in Australia by 2025.