Circulation. 2003;107:2096-2101
Published online before print April 14, 2003, doi: 10.1161/01.CIR.0000065223.21530.11
Published online before print April 14, 2003, doi: 10.1161/01.CIR.0000065223.21530.11
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2003;107:2096.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Prospective Study of Sudden Cardiac Death Among Women in the United States
From the Division of Preventive Medicine (C.M.A., C.U.C., L.M.R., K.M.R., J.E.M.) and Channing Laboratory (F.G., M.J.S., J.E.M.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School; the Cardiovascular Division (C.M.A., C.U.C., J.N.R.), Department of Medicine, Massachusetts General Hospital and Harvard Medical School; and the Department of Epidemiology (F.G., M.J.S., J.E.M.), Harvard School of Public Health, Boston, Mass.
Correspondence to Dr Christine Albert, Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave East, Boston, MA 02215-1204. E-mail calbert{at}partners.org
Background— There are few data regarding the determinants of sudden cardiac death (SCD) in women, primarily because of their markedly lower rate of SCD compared with men. Nonetheless, existing data, although sparse, suggest possible gender differences in risk factors for SCD.
Methods and Results— In this prospective cohort of 121 701 women aged 30 to 55 years at baseline, SCD was defined as death within 1 hour of symptom onset. From 1976 to 1998, 244 SCDs were identified. Although the risk of SCD increased markedly with age, the percentage of cardiac deaths that were sudden decreased. Most (69%) women who suffered a SCD had no history of cardiac disease before their death. However, almost all of the women who died suddenly (94%) had reported at least 1 coronary heart disease risk factor. Smoking, hypertension, and diabetes conferred markedly elevated (2.5- to 4.0-fold) risk of SCD, similar to that conferred by a history of nonfatal myocardial infarction (relative risk, 4.1; 95% confidence interval, 2.9 to 6.7). Family history of myocardial infarction before age 60 years and obesity were associated with moderate (1.6-fold) elevations in risk. With regard to mechanism, 88% of SCDs were classified as arrhythmic. In 76% of these, the first rhythm documented was ventricular tachycardia or ventricular fibrillation.
Conclusions— These prospective data suggest that, as in men, coronary heart disease risk factors predict risk of SCD in women and that SCD is usually an arrhythmic death. Therefore, prevention of atherosclerosis or ventricular arrhythmias may reduce the incidence of SCD in women.
Key Words: death, sudden • women • arrhythmia • coronary disease • risk factors
This article has been cited by other articles:
 |
|
 |
|
  G. B. Young Neurologic Prognosis after Cardiac Arrest N. Engl. J. Med., August 6, 2009; 361(6): 605 - 611. [Full Text] [PDF]
|
|
|
|
 |
|
 E. L. Akylbekova, R. S. Crow, W. D. Johnson, S. G. Buxbaum, S. Njemanze, E. Fox, D. F. Sarpong, H. A. Taylor, and C. Newton-Cheh Clinical Correlates and Heritability of QT Interval Duration in Blacks: The Jackson Heart Study Circ Arrhythm Electrophysiol, August 1, 2009; 2(4): 427 - 432. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Chugh and K. Reinier Predicting Sudden Death in the General Population: Another Step, N Terminal B-Type Natriuretic Factor Levels Circulation, June 9, 2009; 119(22): 2863 - 2864. [Full Text] [PDF]
|
|
|
|
|
|
E. C. Korngold, J. L. Januzzi Jr, M. L. Gantzer, M.V. Moorthy, N. R. Cook, and C. M. Albert Amino-Terminal Pro-B-Type Natriuretic Peptide and High-Sensitivity C-Reactive Protein as Predictors of Sudden Cardiac Death Among Women Circulation, June 9, 2009; 119(22): 2868 - 2876. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Whang, L. D. Kubzansky, I. Kawachi, K. M. Rexrode, C. H. Kroenke, R. J. Glynn, H. Garan, and C. M. Albert Depression and risk of sudden cardiac death and coronary heart disease in women: results from the Nurses' Health Study. J. Am. Coll. Cardiol., March 17, 2009; 53(11): 950 - 958. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Pletcher, L. Lazar, K. Bibbins-Domingo, A. Moran, N. Rodondi, P. Coxson, J. Lightwood, L. Williams, and L. Goldman Comparing Impact and Cost-Effectiveness of Primary Prevention Strategies for Lipid-Lowering Ann Intern Med, February 17, 2009; 150(4): 243 - 254. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Chugh, K. Reinier, T. Singh, A. Uy-Evanado, C. Socoteanu, D. Peters, R. Mariani, K. Gunson, and J. Jui Determinants of Prolonged QT Interval and Their Contribution to Sudden Death Risk in Coronary Artery Disease: The Oregon Sudden Unexpected Death Study Circulation, February 10, 2009; 119(5): 663 - 670. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Cosentino, L. Rydén, P. Francia, and L. G. Mellbin CHAPTER 14 Diabetes Mellitus and Metabolic Syndrome ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. K. Pettee, K. L. Storti, M. B. Conroy, and B. E. Ainsworth A Lifestyle Approach for Primary Cardiovascular Disease Prevention in Perimenopausal to Early Postmenopausal Women American Journal of Lifestyle Medicine, September 1, 2008; 2(5): 421 - 431. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Deo, F. Lin, E. Vittinghoff, Z. H. Tseng, S. B. Hulley, and M. G. Shlipak Kidney Dysfunction and Sudden Cardiac Death Among Women With Coronary Heart Disease Hypertension, June 1, 2008; 51(6): 1578 - 1582. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Albert, E. G. Nam, E. B. Rimm, H. W. Jin, R. J. Hajjar, D. J. Hunter, C. A. MacRae, and P. T. Ellinor Cardiac Sodium Channel Gene Variants and Sudden Cardiac Death in Women Circulation, January 1, 2008; 117(1): 16 - 23. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Lotfi, L. White, T. Rea, L. Cobb, M. Copass, L. Yin, L. Becker, and M. Eisenberg Cardiac Arrest in Schools Circulation, September 18, 2007; 116(12): 1374 - 1379. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. V. d. Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) Eur. Heart J. Suppl., June 1, 2007; 9(suppl_C): C3 - C74. [Full Text] [PDF]
|
|
|
|
|
|
Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol., September 5, 2006; 48(5): e247 - e346. [Full Text] [PDF]
|
|
|
|
 |
|
 Writing Committee Members, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 746 - 837. [Full Text] [PDF]
|
|
|
|
 |
|
 W. Whang, J. E. Manson, F. B. Hu, C. U. Chae, K. M. Rexrode, W. C. Willett, M. J. Stampfer, and C. M. Albert Physical Exertion, Exercise, and Sudden Cardiac Death in Women JAMA, March 22, 2006; 295(12): 1399 - 1403. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. C. Stecker, C. Vickers, J. Waltz, C. Socoteanu, B. T. John, R. Mariani, J. H. McAnulty, K. Gunson, J. Jui, and S. S. Chugh Population-Based Analysis of Sudden Cardiac Death With and Without Left Ventricular Systolic Dysfunction: Two-Year Findings from the Oregon Sudden Unexpected Death Study J. Am. Coll. Cardiol., March 21, 2006; 47(6): 1161 - 1166. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Part 2: Adult Basic Life Support Circulation, November 29, 2005; 112(22_suppl): III-5 - III-16. [Full Text] [PDF]
|
|
|
|
|
|
C. M. Albert, K. Oh, W. Whang, J. E. Manson, C. U. Chae, M. J. Stampfer, W. C. Willett, and F. B. Hu Dietary {alpha}-Linolenic Acid Intake and Risk of Sudden Cardiac Death and Coronary Heart Disease Circulation, November 22, 2005; 112(21): 3232 - 3238. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. A. Whitsel, E. J. Boyko, P. M. Rautaharju, T. E. Raghunathan, D. Lin, R. M. Pearce, S. A. Weinmann, and D. S. Siscovick Electrocardiographic QT Interval Prolongation and Risk of Primary Cardiac Arrest in Diabetic Patients Diabetes Care, August 1, 2005; 28(8): 2045 - 2047. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Thorgeirsson, G. Thorgeirsson, H. Sigvaldason, and J. Witteman Risk factors for out-of-hospital cardiac arrest: the Reykjavik Study Eur. Heart J., August 1, 2005; 26(15): 1499 - 1505. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X. Jouven, J.-P. Empana, P. J. Schwartz, M. Desnos, D. Courbon, and P. Ducimetiere Heart-Rate Profile during Exercise as a Predictor of Sudden Death N. Engl. J. Med., May 12, 2005; 352(19): 1951 - 1958. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Albert, C. U. Chae, K. M. Rexrode, J. E. Manson, and I. Kawachi Phobic Anxiety and Risk of Coronary Heart Disease and Sudden Cardiac Death Among Women Circulation, February 1, 2005; 111(4): 480 - 487. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Psaltopoulou, P. Orfanos, A. Naska, D. Lenas, D. Trichopoulos, and A. Trichopoulou Prevalence, awareness, treatment and control of hypertension in a general population sample of 26 913 adults in the Greek EPIC study Int. J. Epidemiol., December 1, 2004; 33(6): 1345 - 1352. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Klein, L. E. Burke, G. A. Bray, S. Blair, D. B. Allison, X. Pi-Sunyer, Y. Hong, and R. H. Eckel Clinical Implications of Obesity With Specific Focus on Cardiovascular Disease: A Statement for Professionals From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation Circulation, November 2, 2004; 110(18): 2952 - 2967. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Jessup and I. L. Pina Is it important to examine gender differences in the epidemiology and outcome of severe heart failure? J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1247 - 1252. [Full Text] [PDF]
|
|
|
|
|
|
J. B. Schwartz, C. M. Albert, C. U. Chae, F. Grodstein, L. M. Rose, K. M. Rexrode, J. N. Ruskin, M. J. Stampfer, and J. E. Manson Sudden Cardiac Death Among Women in the United States * Response Circulation, November 25, 2003; 108 (21): e153 - e153. [Full Text] [PDF]
|
|
|
|
|
|
S. Mora, R. F. Redberg, Y. Cui, M. K. Whiteman, J. A. Flaws, A. R. Sharrett, and R. S. Blumenthal Ability of Exercise Testing to Predict Cardiovascular and All-Cause Death in Asymptomatic Women: A 20-Year Follow-up of the Lipid Research Clinics Prevalence Study JAMA, September 24, 2003; 290(12): 1600 - 1607. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Nurses' Health Study Identifies Risk Factors for Sudden Cardiac Death Journal Watch Women's Health, June 17, 2003; 2003(617): 8 - 8. [Full Text]
|
|
|
|
 |
|
 Learning More About Risk for Sudden Cardiac Death in Women Journal Watch Cardiology, June 13, 2003; 2003(613): 2 - 2. [Full Text]
|
|