Roadway Proximity and Risk of Sudden Cardiac Death in Women
Background—Sudden cardiac death (SCD) is a major source of mortality and is the first manifestation of heart disease for the majority of cases. Thus, there is a definite need to identify risk factors for SCD that can be modified on the population level. Exposure to traffic, measured by residential roadway proximity, has been shown to be associated with an increased risk of cardiovascular disease. Our objective was to determine if roadway proximity was associated with an increased risk of SCD and to compare to the risk of other coronary heart disease (CHD) outcomes.
Methods and Results—A total of 523 cases of SCD were identified over 26 years of follow-up among 107,130 members of the prospective Nurses' Health Study. We calculated residential distance to roadways at all residential addresses from 1986-2012. In age- and race-adjusted models, women living within 50 meters of a major roadway had an elevated risk of SCD (HR=1.56; 95%CI: 1.18-2.05). The association was attenuated but still statistically significant after controlling for potential confounders and mediators (HR=1.38; 95%CI:1.04-1.82). The equivalent adjusted HRs for nonfatal myocardial infarction and fatal CHD were 1.08 (95%CI: 0.96-1.23) and 1.24 (95%CI: 1.03-1.50), respectively.
Conclusions—Among this sample of middle-aged and older women, roadway proximity was associated with an elevated and statistically significant risks of SCD and fatal CHD, even after controlling for other cardiovascular risk factors.
- Received June 1, 2014.
- Revision received July 29, 2014.
- Accepted August 21, 2014.