Gender differences in sudden cardiac death in the young-a nationwide study

Abstract

BackgroundHitherto, sudden cardiac death (SCD) in the young has been described with no distinction between genders. SCD occurs more often in men (SCDm) than women (SCDw), but this disparity is not understood and has not been investigated systematically in a nationwide setting. Our objective was to report gender differences in SCD in the young in a nationwide (Denmark) setting.MethodsAll deaths in persons aged 1–35 years nationwide in Denmark between 2000 and 2009 were included. Death certificates and autopsy reports were obtained. The extensive health care registries in Denmark were used to investigate any known disease prior to death. SCDw were compared to SCDm.ResultsDuring the 10-year study period there were a total of 8756 deaths in 23.7 million person-years. In total, 635 deaths were SCD. SCDw constituted 205 deaths (32%). Women had a higher proportion of witnessed deaths (51 vs. 41%, p = 0.02) and died less often in a public place (16 vs. 26%, p = 0.01). Age at death, ratios of autopsies and sudden unexplained deaths, and comorbidities, did not differ. Causes of SCD were largely comparable between genders. The incidence rate of SCDw was half of that of SCDm (1.8 vs. 3.6 per 100,000 person-years, incidence rate ratio 2.0 (95% CI 1.7–2.4), p < 0.01).ConclusionsIncidence rate ratio of SCDm vs SCDw is 2. Young SCDw and SCDm are equally investigated, have comparable comorbidity, and causes of SCD. SCD due to potentially inherited cardiac diseases is less often in young women and could reflect a protection of female gender.

Preeclampsia Brings the Risk of Premature Cardiovascular Disease in Women Closer to That of Men

“…4 Middle-aged men are at least twice as likely to develop premature CVD than same-aged female counterparts. [5][6][7][8][9][10][11][12][13] This was consistently observed in the United Kingdom, 14 Australia, 15 United Sates, Canada, 16 and Norway, 17 even upon adjusting for conventional CVD risk factors. 17 It is unclear how sex differences in the risk of premature CVD vary by whether a woman had preeclampsia or not.…”

Male sex increases mortality in ventricular tachyarrhythmias

“…Therefore, it is important to stratify high‐risk patients presenting with ventricular tachyarrhythmias for their individual risk of future outcomes. In general, sex‐related differences of cardiac electrophysiological properties are assumed, whereas precise data in this area are limited especially regarding its pathophysiological background …”

“…In general, sexrelated differences of cardiac electrophysiological properties are assumed, whereas precise data in this area are limited especially regarding its pathophysiological background. [2][3][4][5][6][7][8] In 1920, increased heart rates in women compared to men were described at the very first time. 9 Afterwards a higher incidence of atrial fibrillation and also SCD was shown in men compared to women.…”

“…In contrast, females were associated with a higher risk for ventricular tachyarrhythmias due to sex-related QTc-prolongation. 2,6,10,11 Furthermore, a certain role of steroid hormones, including oestrogen and progesterone for the differentiation of sex-related cardiovascular risk profiles, was reported affecting the regulation of blood pressure, blood flow, vasodilatation, vascular inflammation and atherosclerosis. 12 Genetical determination and hormone-regulated pathways may lead to such pathophysiological alterations.…”

Prevalent Causes of Mortality in the Iranian Population

“…5,6 The coordination of civil services and emergency medical services is warranted to improve and expedite emergency service delivery to victims.…”