- Black people in the United States, especially black women, suffer sudden cardiac death (SCD) at higher rates than do white people.
- Powerful predictive factors include income and education.
- Preventive efforts are needed.
Why this matters
- Black people suffer higher out-of-hospital SCD compared with whites.
- Reasons for disparity have not previously been sought among large community cohorts.
- Over median 27.4-year follow-up, 547 participants experienced SCD.
- SCD cumulative incidence at age 85 years (95% CIs):
- Black men: 9.6% (7.7%-11.5%);
- Black women: 6.6% (5.3%-7.9%);
- White men: 6.5% (5.6%-7.4%); and
- White women: 2.3% (1.8%-2.9%).
- Blacks vs whites, SCD HRs (95% CIs):
- Sex-adjusted: 2.12 (1.79-2.51).
- Adjusted for socioeconomic, cardiovascular, and electrocardiographic risk factors: 1.38 (1.11-1.71).
- Blacks vs whites, excess risks:
- Socioeconomic factors, cardiovascular risk factors, and electrocardiographic variables explained 65.3% (95% CI, 37.9%-92.8%) of the difference.
- Income explained 50.5% of the difference, dwarfing education (19.1%), hypertension (22.1%), and diabetes (19.6%).
- Analysis of multicenter prospective cohort Atherosclerosis Risk in Communities Study (ARIC; 3832 blacks and 11,237 whites).
- Outcome: Cumulative adjudicated SCD incidence; predictive factors.
- Funding: NIH.
- No information on SCD etiologies, access to care, resuscitation.