Related Experiment Video
Updated: Jan 29, 2026
Large-Animal Model of Donation after Circulatory Death and Normothermic Regional Perfusion for Cardiac Assessment
Published on: May 10, 2022
Racial Differences in Sudden Cardiac Death
Di Zhao1, Wendy S Post1,2, Elena Blasco-Colmenares1
1Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (D.Z., W.S.P., E.B.-C., E.D.M., E.G.).
Insights
Blacks face a significantly higher risk of sudden cardiac death (SCD) compared to whites, especially women. Socioeconomic factors like income and education, along with traditional risk factors, explain most of this disparity.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Blacks exhibit a higher incidence of out-of-hospital sudden cardiac death (SCD) than whites.
- Previous research has not fully assessed racial disparities in cumulative SCD risk within large community cohorts.
Purpose of the Study:
- To compare the lifetime cumulative risk of SCD between Black and White populations.
- To identify risk factors contributing to racial differences in SCD risk.
Main Methods:
- A cohort study involving 3832 Black and 11,237 White participants from the Atherosclerosis Risk in Communities Study (ARIC).
- SCD cases were adjudicated, and cumulative incidence was calculated using competing risk models.
- Potential mediating factors included demographics, socioeconomic status, cardiovascular risk factors, and electrocardiographic parameters.
Main Results:
- Over 27.4 years, SCD occurred in 215 Black and 332 White individuals.
- Lifetime cumulative incidence of SCD at age 85 was highest for Black men (9.6%) and lowest for White women (2.3%).
- Known factors explained 65.3% of the excess SCD risk in Blacks versus Whites, with income, education, hypertension, and diabetes being key contributors.
Conclusions:
- Blacks, particularly women, have a substantially higher risk of SCD compared to Whites.
- Socioeconomic and traditional cardiovascular risk factors account for a significant portion of the racial disparity in SCD.
- The observed racial and gender disparities in SCD burden highlight a critical public health and clinical challenge.
Background:
Blacks have a higher incidence of out-of-hospital sudden cardiac death (SCD) in comparison with whites. However, the racial differences in the cumulative risk of SCD and the reasons for these differences have not been assessed in large-scale community-based cohorts. The objective of this study is to compare the lifetime cumulative risk of SCD among blacks and whites, and to evaluate the risk factors that may explain racial differences in SCD risk in the general population.
Methods:
This is a cohort study of 3832 blacks and 11 237 whites participating in the Atherosclerosis Risk in Communities Study (ARIC). Race was self-reported. SCD was defined as a sudden pulseless condition from a cardiac cause in a previously stable individual, and SCD cases were adjudicated by an expert committee. Cumulative incidence was computed using competing risk models. Potential mediators included demographic and socioeconomic factors, cardiovascular risk factors, presence of coronary heart disease, and electrocardiographic parameters as time-varying factors.
Results:
The mean (SD) age was 53.6 (5.8) years for blacks and 54.4 (5.7) years for whites. During 27.4 years of follow-up, 215 blacks and 332 whites experienced SCD. The lifetime cumulative incidence of SCD at age 85 years was 9.6, 6.6, 6.5, and 2.3% for black men, black women, white men, and white women, respectively. The sex-adjusted hazard ratio for SCD comparing blacks with whites was 2.12 (95% CI, 1.79-2.51). The association was attenuated but still statistically significant in fully adjusted models (hazard ratio, 1.38; 95% CI, 1.11-1.71). In mediation analysis, known factors explained 65.3% (95% CI 37.9-92.8%) of the excess risk of SCD in blacks in comparison with whites. The single most important factor explaining this difference was income (50.5%), followed by education (19.1%), hypertension (22.1%), and diabetes mellitus (19.6%). Racial differences were evident in both genders but stronger in women than in men.
Conclusions:
Blacks had a much higher risk for SCD in comparison with whites, particularly among women. Income, education, and traditional risk factors explained ≈65% of the race difference in SCD. The high burden of SCD and the racial-gender disparities observed in our study represent a major public health and clinical problem.
Related Concept Videos
01:16Electric Potential and Potential Difference
When a test charge moves from the initial to the final position, the electric potential difference between those positions is defined as the ratio of the change in the potential energy to the charge on the...
01:05Difference from Background: Limit of Detection
The LOD indicates the presence or absence...
01:14Identifying Statistically Significant Differences: The F-Test
01:22Sum and Difference OpAmps
A summing amplifier, or an adder, utilizes an op-amp to merge multiple input signals into a single output signal. When audio signals are introduced into its input channels, the input resistors initiate currents that traverse feedback resistors, resulting in an output voltage. Applying Kirchhoff's current...
01:18Autophagic Cell Death
Autophagy and Apoptosis
Autophagy can activate apoptosis. In normal conditions, the autophagy activating protein Beclin-1 and...
01:30Overview of Cell Death
Cell death was observed in the early 19th century, but there was no experimental evidence to prove it. In 1842, Carl Vogt first discovered cell death in a metamorphic toad; however, it was not termed ‘cell death.’ Scientists discovered different cell death pathways only in the...