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Sudden cardiac arrest burden greater in blacks than whites
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Compared with whites, blacks have a twofold higher risk for sudden cardiac arrest and are more likely to experience it at a younger age, according to new research published in Circulation.
Researchers compared patient demographics, arrest circumstances and pre-sudden cardiac arrest clinical profiles for individuals prospectively identified in the Oregon Sudden Unexpected Death Study. All individuals had experienced sudden cardiac arrest in the Portland, Oregon area between 2002 and 2012. Physician records were available for 126 blacks and 1,262 whites for the clinical profile comparisons.
The researchers calculated incidence rates during the burden assessment phase (2002-2005), which included 1,077 patients.
Sumeet S. Chugh
Sumeet S. Chugh, MD, associate director of Cedars-Sinai Heart Institute, and colleagues found that age-adjusted rates of sudden cardiac arrest were doubled in blacks compared with whites. Black men had a rate of 175 per 100,000 people compared with 84 per 100,000 people for white men. Among black women, the rate was 90 per 100,000 people, compared with 40 per 100,000 people among white women.
Blacks were more than 6 years younger than whites at the time of their sudden cardiac arrest, according to the researchers. In addition, 58% of blacks were aged younger than 65 years at the time of their arrest, compared with 43% of whites.
Chugh and colleagues also found that before sudden cardiac arrest, blacks had a higher prevalence of diabetes (52% of patients vs. 33%; P < .0001), hypertension (77% vs. 65%; P = .006), chronic renal insufficiency (34% vs. 19%; P < .0001), congestive HF (43% vs. 34%; P = .04) and left ventricular hypertrophy (77% vs. 58%; P = .02) compared with whites.
Blacks also had a longer QT interval compared with whites (466 ± 36 ms vs. 453 ± 41 ms; P = .03), but there were no differences between blacks and whites in previously documented CAD or LV dysfunction.
“Cardiac arrest is recognized by the `bad company’ it keeps, so the mantra has been: prevent [CAD], prevent sudden cardiac death,” Chugh said in a press release. “As health care professionals, we should be aware of a broader spectrum of risk factors for our black patients. If we only focus on reducing [CAD], we are unlikely to offer them the same benefit we offer white patients.” – by Erik Swain
Disclosure: One researcher reports receiving research grants from Biotronik and Boston Scientific.
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