Related Experiment Videos
Comparison of sudden and nonsudden coronary deaths in the United States
1Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Ga 30333, USA.
Insights
Sudden coronary death is more strongly linked to cigarette smoking than other types of coronary death. Contrary to popular belief, home deaths are more often nonsudden coronary events.
Area of Science:
- Cardiovascular Research
- Public Health
- Epidemiology
Background:
- Investigating risk factors for coronary heart disease (CHD) deaths.
- Differentiating between sudden coronary death (within 1 hour of symptom onset), nonsudden coronary death, and other coronary death.
Purpose of the Study:
- To compare the prevalence of risk factors in sudden vs. nonsudden coronary deaths.
- To analyze socioeconomic status, location at death, and CHD risk factors associated with sudden coronary death.
Main Methods:
- Utilized data from the 1986 National Mortality Followback Survey and US Bureau of the Census.
- Employed multivariate logistic regression to calculate odds ratios (OR) for sudden coronary death.
- Examined age, sex, education, ethnicity, location, smoking, and other modifiable risk factors.
Main Results:
- Mortality rates for all coronary deaths increased with age, were higher in men, and decreased with more education.
- Sudden coronary deaths were less likely to occur at home (OR=0.5) but more likely among current cigarette smokers (OR=1.3).
- Hispanic individuals had the highest rate of sudden coronary death.
Conclusions:
- Home deaths are more frequently nonsudden than sudden, challenging common assumptions.
- Cigarette smoking is a significant risk factor for sudden coronary death, potentially due to nicotine-induced arrhythmias.
- No other modifiable CHD risk factors differentiated sudden from nonsudden coronary deaths.
Background:
The present study was designed to compare risk factor prevalences in coronary heart disease deaths in persons dying within 1 hour of onset of cardiovascular symptoms (sudden coronary death), those dying without such sudden symptoms (nonsudden coronary death), and those with unknown duration of symptoms before death (other coronary death).
Methods And Results:
Data from the 1986 National Mortality Followback Survey and the US Bureau of the Census were examined to assess death rates for sudden, nonsudden, and other coronary deaths. Multivariate logistic regression methods were used to calculate the odds ratio (OR), compared with nonsudden and other coronary deaths, for sudden coronary death associated with socioeconomic status variables, the person's location at death, and coronary heart disease risk factors. Mortality rates for all coronary deaths increased with age, were higher for men than women, and increased with decreasing years of schooling. The rate of sudden coronary death was highest for Hispanics. In 1986, an estimated 251,000 sudden coronary deaths (95% CI = 238,000 to 263,000) occurred in the United States. Sudden coronary deaths were less likely than nonsudden coronary deaths to occur at home (OR = 0.5, 95% CI = 0.4 to 0.6), but individuals who died of sudden coronary death were more likely to have been current cigarette smokers (OR = 1.3, 95% CI = 1.0 to 1.8). No other modifiable risk factors for coronary heart disease distinguished sudden coronary deaths from nonsudden coronary deaths.
Conclusions:
Contrary to the commonly held view, coronary deaths in the home are more likely to be nonsudden than sudden. Cigarette smoking more likely results in sudden than nonsudden coronary death, perhaps because of nicotine-induced ventricular arrhythmias.