Blacks’ risk of sudden cardiac death three times that of Whites

DR. ELISEO GUALLAR

Sure, February is Black History Month, but it’s also Heart Month for the American Heart Association, and earlier this month it announced the release of a new study out of Johns Hopkins University that notes African Americans are at double to triple the risk for cardiac arrest as their White counterparts.
First, cardiac arrest is not the same as a heart attack. Though heart attacks can certainly lead to cardiac arrest, the proximate cause in each is different. Heart attacks are caused by blockages that stop blood flow and kill heart muscle tissue—they are circulation problems.
Cardiac arrest is an electrical problem that causes the heart to beat chaotically—and stop. Two common arrhythmias are ventricular fibrillation (VF)—where one or both of the lower chambers beat chaotically, and tachycardia—a racing heartbeat.
Both can be treated with medications. And while VF may need to be treated by implanting a pacemaker, tachycardia that does not respond to medication can only be treated by catheter ablation, which uses radio waves to destroy the area of heart tissue that triggers the tachycardia.
While a racing heartbeat is apparent to those who experience it, the warning signs of VF are less clear and include: fatigue, dizziness, chest pressure, nausea and shortness of breath.
The Feb. 4 study published in the Circulation Journal looked at large longitudinal samples including 11,237 Whites and 3,832 African Americans, some of whom were followed for up to 27 years. It found that by age 85, the risk for sudden cardiac death was:
•9.6 percent for African American males;
•6.5 percent for White males;
•6.6 percent for African American females, and
•2.3 percent for White females.
Lead author of the study, Eliseo Guallar, M.D., Ph.D., from the Johns Hopkins University Bloomberg School of Public Health, said income and educational disparities were the main factors explaining the racial differences in risk. According to the study, income, education, hypertension, diabetes, and other cardiovascular risk factors accounted for about 65 percent of the difference.
“We wanted to explain the risk of sudden cardiac death and identify factors that could explain the differences,” Dr. Guallar said. “We found that overall, African Americans had approximately double the lifetime risk of sudden cardiac death compared to Whites. African American women had about triple the risk compared to White women.”
“Low income and education are associated with unhealthy behaviors, low disease awareness and limited access to care, which could all contribute to poor outcomes,” he added. “However, our understanding of the mechanisms for racial differences in sudden cardiac death is still incomplete and additional research is needed.”
Still, the researchers say their findings point to the need for better prevention methods and access to cardiac care, especially among African Americans. Those efforts would include control of cardiovascular risk factors such as high blood pressure and expanding the number of people trained in cardiopulmonary resuscitation (CPR), especially in predominantly African American neighborhoods.
 
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