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Lifetime Risk for Sudden Cardiac Death in the Community

View Article: PubMed Central - PubMed

ABSTRACT

Background: Sudden cardiac death (SCD) is a leading cause of death in the United States and often occurs without previous cardiac symptoms. Lifetime risk for SCD and the influence of established risk factors on lifetime risks for SCD have not been estimated previously.

Methods and results: We followed Framingham Heart Study participants who were free of cardiovascular disease before their earliest examination. SCD was defined as death attributed to coronary heart disease within 1 hour of symptom onset without another probable cause of death, as adjudicated by a panel of 3 physicians. Lifetime risk for SCD was estimated to 85 years of age for men and women, with death attributed to other causes as the competing risk, and stratified by risk factor levels. We followed 2294 men and 2785 women for 160 396 person‐years; 375 experienced SCD. At 45 years of age, lifetime risks were 10.9% (95% CI, 9.4–12.5) for men and 2.8% (95% CI, 2.1–3.5) for women. Greater aggregate burden of established risk factors was associated with a higher lifetime risk for SCD. Categorizing men and women solely by blood pressure levels resulted in a clear stratification of lifetime risk curves.

Conclusions: We present the first lifetime risk estimates for SCD. Greater aggregate risk factor burden, or blood pressure level alone, is associated with higher lifetime risks for SCD. This high risk of premature death attributed to SCD (approximately 1 in 9 men and 1 in 30 women) should serve as a motivator of public health efforts in preventing and responding to SCD.

No MeSH data available.


Related in: MedlinePlus

Lifetime risk for SCD at index age 75 years, stratified by aggregate risk factor burden and sex. Lifetime risk of men and women with ≥2 major risk factors at index age 75 does not statistically differ from those with all optimal risk factor burden. SCD indicates sudden cardiac death.
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jah31584-fig-0004: Lifetime risk for SCD at index age 75 years, stratified by aggregate risk factor burden and sex. Lifetime risk of men and women with ≥2 major risk factors at index age 75 does not statistically differ from those with all optimal risk factor burden. SCD indicates sudden cardiac death.

Mentions: Adjusted cumulative risk curves for SCD by sex and aggregate risk factor strata at index age 45 years are displayed in Figure 1. Data for index ages 55, 65, and 75 years are displayed in Figures 2, 3 through 4, respectively. Significant differences in lifetime risk (P<0.05) between those with all optimal risk factor burden compared to those with at least 2 major risk factors are noted in the figure captions. Overall, participants with 1 or at least 2 major risk factor strata had higher lifetime risk estimates for SCD compared to those with all optimal risk factor levels at all selected index ages; however, those differences were not significant for men or women at index ages 65 and 75. For instance, women at index age 55 had an adjusted cumulative lifetime risk of SCD to age 85 years of 0% for those in the all optimal risk burden category, 1.6% for those with ≥1 not optimal risk factor, 2.4% for those with at least 1 elevated risk factor, 3.2% for those with 1 major risk factor, and 5.1% for those with at least 2 major risk factors. For women at index age 55, lifetime risk to age 85 was significantly different (P<0.05) for women with all optimal risk burden when compared to those with 1 major risk factor or at least 2 major risk factors. Lifetime risk of women at index age 55 in ≥1 Not Optimal (1.6%) or ≥1 Elevated (2.4%) groups was significantly different (P<0.05) when compared to those with at least 2 major risk factors (5.1%).


Lifetime Risk for Sudden Cardiac Death in the Community
Lifetime risk for SCD at index age 75 years, stratified by aggregate risk factor burden and sex. Lifetime risk of men and women with ≥2 major risk factors at index age 75 does not statistically differ from those with all optimal risk factor burden. SCD indicates sudden cardiac death.
© Copyright Policy - creativeCommonsBy-nc
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5015355&req=5

jah31584-fig-0004: Lifetime risk for SCD at index age 75 years, stratified by aggregate risk factor burden and sex. Lifetime risk of men and women with ≥2 major risk factors at index age 75 does not statistically differ from those with all optimal risk factor burden. SCD indicates sudden cardiac death.
Mentions: Adjusted cumulative risk curves for SCD by sex and aggregate risk factor strata at index age 45 years are displayed in Figure 1. Data for index ages 55, 65, and 75 years are displayed in Figures 2, 3 through 4, respectively. Significant differences in lifetime risk (P<0.05) between those with all optimal risk factor burden compared to those with at least 2 major risk factors are noted in the figure captions. Overall, participants with 1 or at least 2 major risk factor strata had higher lifetime risk estimates for SCD compared to those with all optimal risk factor levels at all selected index ages; however, those differences were not significant for men or women at index ages 65 and 75. For instance, women at index age 55 had an adjusted cumulative lifetime risk of SCD to age 85 years of 0% for those in the all optimal risk burden category, 1.6% for those with ≥1 not optimal risk factor, 2.4% for those with at least 1 elevated risk factor, 3.2% for those with 1 major risk factor, and 5.1% for those with at least 2 major risk factors. For women at index age 55, lifetime risk to age 85 was significantly different (P<0.05) for women with all optimal risk burden when compared to those with 1 major risk factor or at least 2 major risk factors. Lifetime risk of women at index age 55 in ≥1 Not Optimal (1.6%) or ≥1 Elevated (2.4%) groups was significantly different (P<0.05) when compared to those with at least 2 major risk factors (5.1%).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Sudden cardiac death (SCD) is a leading cause of death in the United States and often occurs without previous cardiac symptoms. Lifetime risk for SCD and the influence of established risk factors on lifetime risks for SCD have not been estimated previously.

Methods and results: We followed Framingham Heart Study participants who were free of cardiovascular disease before their earliest examination. SCD was defined as death attributed to coronary heart disease within 1&nbsp;hour of symptom onset without another probable cause of death, as adjudicated by a panel of 3 physicians. Lifetime risk for SCD was estimated to 85&nbsp;years of age for men and women, with death attributed to other causes as the competing risk, and stratified by risk factor levels. We followed 2294 men and 2785 women for 160&nbsp;396&nbsp;person&#8208;years; 375 experienced SCD. At 45&nbsp;years of age, lifetime risks were 10.9% (95% CI, 9.4&ndash;12.5) for men and 2.8% (95% CI, 2.1&ndash;3.5) for women. Greater aggregate burden of established risk factors was associated with a higher lifetime risk for SCD. Categorizing men and women solely by blood pressure levels resulted in a clear stratification of lifetime risk curves.

Conclusions: We present the first lifetime risk estimates for SCD. Greater aggregate risk factor burden, or blood pressure level alone, is associated with higher lifetime risks for SCD. This high risk of premature death attributed to SCD (approximately 1 in 9 men and 1 in 30 women) should serve as a motivator of public health efforts in preventing and responding to SCD.

No MeSH data available.


Related in: MedlinePlus