Racial Differences in Sudden Cardiac Death

Abstract

Background: African Americans (AAs) have a higher incidence of out-of-hospital sudden cardiac death (SCD) compared with Whites. However, the racial differences in the cumulative risk of SCD and the reasons for these differences have not been assessed in large-scale communitybased cohorts. The objective of this study is to compare the lifetime cumulative risk of SCD among AAs and Whites, and to evaluate the risk factors that may explain racial differences in SCD risk in the general population. Methods: Cohort study of 3,832 AAs and 11,237 Whites participating in the Atherosclerosis Risk in Communities (ARIC) Study. Race was self-reported. SCD was defined as a sudden pulseless condition from a cardiac cause in a previously stable individual and SCD cases were adjudicated by an expert committee. Cumulative incidence was computed using competing risk models. Potential mediators included demographic and socioeconomic factors, cardiovascular risk factors, presence of coronary heart disease and electrocardiographic parameters as time-varying factors.

Bringing Critical Race Praxis into the Study of Electrophysiological Substrate of Sudden Cardiac Death: The Atherosclerosis Risk in Communities (ARIC) Study

“…Many previous studies recognized race as an independent and strong risk factor of SCD even after adjusting for socioeconomic factors but attributed it -at least partiallyto underlying biological differences between black and white individuals. 1,2,4 In contrast, our comprehensive study of EP substrate did not find meaningful effect modification by race. Results of our study call attention to structural racism as an important determinant of the increased SCD rate in black as compared to white individuals.…”

“…Based on a recent study demonstrating a significantly stronger association of hypertension with SCD in black as compared to white individuals, 1 we additionally constructed a set of models that included interaction with both race and hypertension categories. The white hypertension-free subgroup was the reference.…”

“…Sudden cardiac death (SCD) disproportionately affects black individuals, with a nearly twofold increased risk of SCD in black as compared to white individuals. [1][2][3] Socioeconomic disparities and the burden of cardiovascular (CV) risk have been proposed as factors that may underlie the observed racial differences in SCD. 1 However, adjustment for socioeconomic and behavioral measures of health does not fully explain an excess of SCD risk in black individuals.…”

“…[1][2][3] Socioeconomic disparities and the burden of cardiovascular (CV) risk have been proposed as factors that may underlie the observed racial differences in SCD. 1 However, adjustment for socioeconomic and behavioral measures of health does not fully explain an excess of SCD risk in black individuals. 1,2,4 Moreover, the large prospective community-based cohort the Atherosclerosis Risk in Communities (ARIC) study showed that race modifies an association of several major risk factors with SCD.…”

Do GLP‐1RAs and SGLT‐2is reduce cardiovascular events in black patients with type 2 diabetes? A systematic review and meta‐analysis

“…35,36 In addition, it was shown that black and African American individuals are at increased risk of sudden cardiac death compared to white individuals. 37 Because of these differences, it may be early to assume that diabetes medications that improve cardiovascular benefit in white patients would produce similar results in black patients. Given this concern, and the high burden of cardiovascular disease in black and African American patients, with or without diabetes, it is crucial to evaluate diabetes regimens that would reduce such major complications and might lessen the racial disparities that persist in cardiovascular outcomes.…”