51. Differences in Risk of Sudden Cardiac Death Between Blacks and Whites
- Author
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Deo, Rajat, Safford, Monika M, Khodneva, Yulia A, Jannat-Khah, Deanna P, Brown, Todd M, Judd, Suzanne E, McClellan, William M, Rhodes, J David, Shlipak, Michael G, Soliman, Elsayed Z, and Albert, Christine M
- Subjects
Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Cardiovascular ,Clinical Research ,Heart Disease ,Prevention ,2.4 Surveillance and distribution ,Aetiology ,Good Health and Well Being ,Aged ,Alcohol Drinking ,Arrhythmias ,Cardiac ,Black People ,Cohort Studies ,Death ,Sudden ,Cardiac ,Female ,Follow-Up Studies ,Humans ,Male ,Middle Aged ,Prospective Studies ,Risk Factors ,Smoking ,United States ,White People ,epidemiology ,population science ,race ,risk factor ,risk stratification ,sudden cardiac death ,Cardiorespiratory Medicine and Haematology ,Public Health and Health Services ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology - Abstract
BackgroundPrior studies have consistently demonstrated that blacks have an approximate 2-fold higher incidence of sudden cardiac death (SCD) than whites; however, these analyses have lacked individual-level sociodemographic, medical comorbidity, and behavioral health data.ObjectivesThe purpose of this study was to evaluate whether racial differences in SCD incidence are attributable to differences in the prevalence of risk factors or rather to underlying susceptibility to fatal arrhythmias.MethodsThe Reasons for Geographic and Racial Differences in Stroke study is a prospective, population-based cohort of adults from across the United States. Associations between race and SCD defined per National Heart, Lung, and Blood Institute criteria were assessed.ResultsAmong 22,507 participants (9,416 blacks and 13,091 whites) without a history of clinical cardiovascular disease, there were 174 SCD events (67 whites and 107 blacks) over a median follow-up of 6.1 years (interquartile range: 4.6 to 7.3 years). The age-adjusted SCD incidence rate (per 1,000 person-years) was higher in blacks (1.8; 95% confidence interval [CI]: 1.4 to 2.2) compared with whites (0.7; 95% CI: 0.6 to 0.9), with an unadjusted hazard ratio of 2.35; 95% CI: 1.74 to 3.20. The association of black race with SCD risk remained significant after adjustment for sociodemographics, comorbidities, behavioral measures of health, intervening cardiovascular events, and competing risks of non-SCD mortality (hazard ratio: 1.97; 95% CI: 1.39 to 2.77).ConclusionsIn a large biracial population of adults without a history of cardiovascular disease, SCD rates were significantly higher in blacks as compared with whites. These racial differences were not fully explained by demographics, adverse socioeconomic measures, cardiovascular risk factors, and behavioral measures of health.
- Published
- 2018