Sudden death not surprising in many women

April 14, 2003

DALLAS, April 15 - Most women who die from an abrupt loss of heart function (called sudden cardiac death) have no prior history of heart disease. However, 94 percent of these women have at least one cardiac risk factor such as smoking, high blood pressure, high cholesterol, diabetes or obesity, according to a report in today's rapid access issue of Circulation: Journal of the American Heart Association.

Sudden cardiac death (SCD) has been understudied in women because it is more common among men, says Christine M. Albert, M.D., M.P.H., lead author of the study and an assistant professor of medicine at Harvard Medical School, Boston. There are an estimated 400,000 out-of-hospital or emergency room sudden cardiac deaths each year.

"There are also data to suggest that risk factors for this type of cardiac death may be different among women," she adds. "That's why we wanted to take a closer look at women in this study. As far as I'm aware, this is the largest number of sudden cardiac deaths in women that have been examined."

The researchers analyzed data from the Nurses' Health Study, which included 121,701 women ages 30 to 55. The study followed the women for 22 years (1976 to 1998), documenting medical history, cardiac risk factors, diagnosed disease and death. There were 244 cases of SCD in the study. Sudden cardiac death was defined as death within one hour of the onset of symptoms.

Albert and colleagues found that in 69 percent of the SCD deaths, sudden cardiac death was the first sign of heart disease. However, almost all the women who died suddenly had at least one cardiac risk factor. "Smoking should be emphasized as a very strong risk factor," Albert says. "The women who smoked 25 or more cigarettes a day had a four-fold increased risk of sudden cardiac death. This level of risk is similar to that of a woman who had a heart attack in the past."

Diabetes was associated with almost a three-fold increased risk of sudden death; hypertension with about a 2.5-fold increased risk; and obesity with a 1.6-fold increased risk. High cholesterol did not appear to significantly elevate risk for sudden cardiac death.

Family history was a risk factor for SCD if the women had a parent who died from it before age 60. "So it appears that a genetic factor might be involved, particularly among women who die suddenly at a young age," Albert says.

Albert says the concern is that doctors tend to focus on preventing SCD in patients with documented heart disease and not those with risk factors only. "This is not the first study to find that cardiac sudden death usually occurs in people without a history of heart disease," she says.

The researchers also confirmed that the most likely mode of sudden cardiac death is irregular heart rhythm. Research has shown that most sudden cardiac deaths in men are caused by a ventricular arrhythmia (a chaotic heart rhythm). The same appears to be true of women, Albert says.

The authors conclude that heart disease risk factors appear to predispose women to sudden cardiac death, just as with men. Albert says the study results imply, but don't prove, that by modifying risk factors (quitting smoking, healthy eating, and controlling blood pressure, cholesterol and diabetes), people might lower their risks for sudden cardiac death.

"The research tells doctors and patients that sudden cardiac death does happen to women and not just women with heart disease. The first sign of heart disease might very well be sudden cardiac death," Albert says. "The best advice now is for women to lower their risk of coronary heart disease, which might lower their risk of sudden cardiac death. These results highlight the need for more research to better identify women who are at high risk for this devastating event."

Co-authors are Claudia U. Chae, M.D., M.P.H.; Francine Grodstein, Sc.D.; Lynda M. Rose, M.S.; Kathryn M. Rexrode, M.D., M.P.H.; Jeremy N. Ruskin, M.D.; Meir J. Stampfer, M.D., Dr.P.H.; and JoAnn E. Manson, M.D., Dr.P.H. This research was funded by the National Institutes of Health.
Editor's notes: To help women reduce their risk for cardiovascular disease - the No. 1 cause of death for American women - the American Heart Association offers Simple Solutions. This FREE education program helps women incorporate simple healthy changes into their lives to improve their heart health. Join Simple Solutions by logging on to If someone you know experiences sudden cardiac death, be prepared to call 9-1-1, give immediate, effective CPR and use a defibrillator within a few minutes. The American Heart Association's Operation Heartbeat program and CPR and AED training can help make this possible. For more information, call 1-877-AHA-4CPR or visit

CONTACT: For journal copies only,
please call: 214-706-1396
For other information, call:
Carole Bullock: 214-706-1279
Maggie Francis: 214-706-1397

American Heart Association

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to