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Burden of Sudden Cardiac Death Higher in Black Men, Women

Known factors explain 65.3 percent of excess SCD risk in African-Americans, especially women

circulatory system

TUESDAY, Feb. 5, 2019 (Pharmacist's Briefing) -- African-Americans have a higher burden of sudden cardiac death (SCD) than whites, especially among women, according to a study published online Feb. 4 in Circulation.

Di Zhao, Ph.D., from the Johns Hopkins University Bloomberg School of Public Health in Baltimore, and colleagues conducted a cohort study of 3,832 black and 11,237 white individuals participating in the Atherosclerosis Risk in Communities Study. The authors sought to compare the lifetime cumulative risk for SCD.

The researchers found that 215 blacks and 332 whites experienced SCD during 27.4 years of follow-up. At age 85 years, the lifetime cumulative incidence of SCD was 9.6, 6.6, 6.5, and 2.3 percent for black men, black women, white men, and white women, respectively. Comparing blacks with whites, the sex-adjusted hazard ratio for SCD was 2.12. In fully adjusted models, the association was attenuated but still statistically significant (hazard ratio, 1.38). Known factors explained 65.3 percent of the excess risk for SCD for blacks versus whites in mediation analysis. The most important factors explaining this difference were income, education, hypertension, and diabetes mellitus (50.5, 19.1, 22.1, and 19.6 percent, respectively). In both genders, racial differences were evident, but they were stronger in women than men.

"Further studies are needed to elucidate the underlying cause of increased SCD risk in blacks, and determine whether targeted clinical practice that takes race into account can provide a better approach for risk-stratified prevention and therapy for SCD," the authors write.

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