TUESDAY, April 15, 2003 (HealthDayNews) -- Doctors should pay the same attention to preventing sudden cardiac death in women as they do for men, a new Harvard study urges.
Admittedly, the rate of sudden cardiac death is lower in women than in men -- only 30 percent of the 400,000 sudden deaths that happen in the United States each year occur in women, lead author Dr. Christine M. Albert says in a statement. But there seems to be an assumption that the conventional risk factors for heart disease -- such as smoking, high blood pressure, obesity and diabetes -- don't raise a warning flag for women as they do for men, she adds.
However, analysis of the Nurses' Health Study, which followed more than 121,000 women for 20 years, say otherwise. The research appears in the April 15 issue of Circulation.
"Our data suggest that coronary heart disease risk factors do indeed predict sudden coronary death in women, and therefore coronary heart disease risk factor intervention should impact risk of sudden cardiac death in women," the study says.
True, for 69 percent of the 244 women who suffered sudden deaths recorded in the study, death was the first sign of heart disease, Albert acknowledges. But almost every one of those women had a significant cardiac risk factor. For example, diabetes was associated with a 2.5-fold increased risk and obesity was linked with a 1.6-fold increase. Oddly, high blood cholesterol did not raise the risk significantly.
Smoking was the real killer. "The women who smoked 25 or more cigarettes a day had a fourfold increased risk of sudden cardiac death," Albert says.
"A genetic factor might be involved, particularly among women who die suddenly at a young age," Albert says. Family history was a risk factor if a woman had a parent who suffered sudden cardiac death before the age of 60.
The study does upset one belief about the difference between men and women. Many people assume sudden cardiac death is caused by a heart attack. In fact, a more common cause is ventricular fibrillation, a violent interruption of the rhythm of the blood-pumping chambers of the heart. It has been believed that sudden deaths in women were less likely to be caused by an arrhythmia. The report finds the cause of death was about the same for men and women: 88 percent in this study compared to 91 percent in a recent study of men.
However, there is one disturbing difference between the sexes. The incidence of sudden cardiac death in men appears to be declining, down 2.8 percent between 1989 and 1999 for men between the ages of 35 and 44. In women, meanwhile, it rose 21 percent in the same age group in that period.
The report means that more emphasis should be placed on detecting and treating risk factors in women, says Dr. Nieca Goldberg, a cardiologist at Lenox Hill Hospital in New York City and a spokeswoman for the American Heart Association.
"It has been shortsighted in terms of the medical community ignoring symptoms for a lot of women detected in screening," Goldberg says. "Smoking, diabetes and hypertension [high blood pressure] needed to be screened for and aggressively treated."
More information
You can learn about sudden cardiac death and what can be done to prevent it from the American Heart Association. You can also try the National Heart, Lung, and Blood Institute's Women's Heart Health Education Initiative.
