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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.).

Circulation
|February 5, 2019
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
cohort studiesracerisk factorssudden cardiac death

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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.