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Racial differences in sudden cardiac death among hypertensive patients during antihypertensive therapy: the LIFE

Peter M Okin1, Sverre E Kjeldsen, Stevo Julius

  • 1Division of Cardiology, Weill Cornell Medical College, Cornell University, New York, New York 10065, USA. pokin@med.cornell.edu

Heart Rhythm
|November 15, 2011
PubMed

Insights

Black hypertensive patients face a significantly higher risk of sudden cardiac death (SCD). This increased risk persists even after accounting for other known risk factors, highlighting a critical health disparity.

Area of Science:

  • Cardiology
  • Public Health
  • Hypertension Research

Background:

  • General population data suggest a higher risk of sudden cardiac death (SCD) among Black individuals.
  • Hypertension is a significant risk factor for cardiovascular events, including SCD.

Purpose of the Study:

  • To investigate the incidence of sudden cardiac death (SCD) specifically in Black patients with hypertension.
  • To determine if race is an independent predictor of SCD in hypertensive individuals.

Main Methods:

  • A cohort study involving 533 Black and 8660 non-Black hypertensive patients.
  • Patients were randomly assigned to losartan- or atenolol-based treatment regimens.
  • Follow-up averaged 4.8 years, with SCD incidence meticulously recorded.

Main Results:

  • The 5-year incidence of SCD was substantially higher in Black hypertensive patients (3.9%) compared to non-Black patients (1.9%).
  • Univariate analysis revealed a 97% increased risk of SCD in Black patients (HR 1.97).
  • Multivariate analysis, controlling for numerous clinical and demographic factors, confirmed a persistent 98% increased risk of SCD in Black patients (HR 1.98).

Conclusions:

  • Black hypertensive patients exhibit an elevated risk of sudden cardiac death (SCD).
  • This heightened SCD risk in Black patients remains significant even after adjusting for prevalent risk factors, blood pressure control, and electrocardiographic markers.
  • Findings underscore the need for targeted strategies to mitigate SCD risk in this vulnerable population.
Abstract

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