Abstract 12974: Primary Prevention of Sudden Cardiac Death in Women
Background: Sudden cardiac death (SCD) accounts for over half of all cardiac deaths, and the majority occur as the first manifestation of heart disease, especially among women. Primary preventive strategies are needed to reduce SCD incidence. Lifestyle and dietary interventions, which are suitable for use in large populations, may lower mortality from CVD through the reduction in the incidence of SCD.
Objective: To estimate the degree to which adherence to a healthy lifestyle may lower risk of SCD among women.
Methods: We followed 78,379 women from the Nurses' Health Study, who were free of major chronic diseases in 1984. Lifestyle factors were updated via questionnaires every 2–4 years. A low risk, healthy lifestyle was defined as not currently smoking, BMI <25 kg/m2, moderate activity for >30 minutes/day, moderate alcohol intake (1/2–1 drink/day), and top 40% of the Healthy Diet Score 2010, which emphasizes nuts, fruits, vegetables, whole grains, marine omega-3 and other polyunsaturated fats, and minimizes red and processed meats, sugar-sweetened beverages and trans fat. SCD was defined as death occurring within 1 hour of symptom onset without evidence of circulatory collapse. We calculated the population attributable risk (PAR) to estimate the proportion of SCD attributable to unhealthy lifestyle habits.
Results: We documented 255 cases of SCD over 25 years. Compared to women with <2 healthy lifestyle factor, the multivariate relative risk of SCD was 0.67 (95%CI: 0.50, 0.89), 0.50 (95%CI: 0.35, 0.71) and 0.23 (95%CI: 0.12, 0.44) for women with 2, 3, and 4+ healthy lifestyle factors, respectively. The proportion of SCD attributable to smoking, inactivity, overweight, and poor dietary habits in this population was 65% (95%CI: 28%, 85%). When alcohol intake was also taken into consideration, the PAR associated with all 5 factors was 76% (95%CI: 12%, 97%). Only 1 SCD event occurred among the 2% of women at low risk for all 5 factors.
Conclusions: The majority of SCD in this population may be attributed to poor adherence to a low risk lifestyle of not smoking, daily exercise, a healthy diet and healthy weight. Primary prevention of SCD through adoption of a healthy lifestyle is one strategy to meet the AHA 2020 Impact Goal of reducing deaths from CVD among Americans by 20%.
- © 2010 by American Heart Association, Inc.