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Sudden Cardiac Death Risk Distribution in the United States Population (from NHANES, 2005 to 2012).

ABSTRACT: Sudden cardiac death (SCD) accounts for more than half of all deaths from cardiovascular disease and is the first manifestation of heart disease in 50% of these subjects. We aimed to describe the distribution of predicted SCD risk in the general US population using a recently developed risk score. We previously developed a population-based, 10-year risk score for SCD using data from the multiracial Atherosclerosis Risk in Communities cohort, validated in the Framingham Study. We now estimate 10-year predicted SCD risk in National Health and Nutrition Examination Survey participants (pooled from cycles in 2005 to 2012) and evaluate the clinical profile of participants in lower risk (0 to 80th percentile of risk) or high risk (81st to 100th percentile of risk) strata. A total of 10,811 participants were included; the mean age of participants was 48 years, and 50% were women. The average predicted 10-year risk of SCD was 3.6% in high-risk participants (81st to 100th percentile), and 0.37% in low-risk participants (0 to 80th percentile). High-risk participants were older, had higher blood pressure, total cholesterol and body mass index, lower high-density lipoprotein, and were more likely to be men, black, smokers, and diabetic. In US adults free of cardiovascular disease, the majority of SCD risk appears confined to 10% to 20% of the population. This risk score, comprised of readily available clinical variables, identifies a subset of individuals in the population who are at an appreciably higher risk of SCD. This enriched cohort represents candidates for additional nuanced and selective screening techniques to further quantify SCD risk.

SUBMITTER: Olson KA

PROVIDER: S-EPMC6435391 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Sudden Cardiac Death Risk Distribution in the United States Population (from NHANES, 2005 to 2012).

Olson Kristoff A KA Patel Ravi B RB Ahmad Faraz S FS Ning Hongyan H Bogle Brittany M BM Goldberger Jeffrey J JJ Lloyd-Jones Donald M DM

The American journal of cardiology 20190125 8

Sudden cardiac death (SCD) accounts for more than half of all deaths from cardiovascular disease and is the first manifestation of heart disease in 50% of these subjects. We aimed to describe the distribution of predicted SCD risk in the general US population using a recently developed risk score. We previously developed a population-based, 10-year risk score for SCD using data from the multiracial Atherosclerosis Risk in Communities cohort, validated in the Framingham Study. We now estimate 10- ...[more]

PMID: 30808515

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Project description:ObjectiveTo assess the association between risk of sudden cardiac death and stressful law enforcement duties compared with routine/non-emergency duties.DesignCase distribution study (case series with survey information on referent exposures).SettingUnited States law enforcement.ParticipantsSummaries of deaths of over 4500 US police officers provided by the National Law Enforcement Officers Memorial Fund and the Officer Down Memorial Page from 1984 to 2010.Main outcome measuresObserved and expected sudden cardiac death counts and relative risks for sudden cardiac death events during specific strenuous duties versus routine/non-emergency activities. Independent estimates of the proportion of time that police officers spend across various law enforcement duties obtained from surveys of police chiefs and front line officers. Impact of varying exposure assessments, covariates, and missing cases in sensitivity and stability analyses.Results441 sudden cardiac deaths were observed during the study period. Sudden cardiac death was associated with restraints/altercations (25%, n=108), physical training (20%, n=88), pursuits of suspects (12%, n=53), medical/rescue operations (8%, n=34), routine duties (23%, n=101), and other activities (11%, n=57). Compared with routine/non-emergency activities, the risk of sudden cardiac death was 34-69 times higher during restraints/altercations, 32-51 times higher during pursuits, 20-23 times higher during physical training, and 6-9 times higher during medical/rescue operations. Results were robust to all sensitivity and stability analyses.ConclusionsStressful law enforcement duties are associated with a risk of sudden cardiac death that is markedly higher than the risk during routine/non-emergency duties. Restraints/altercations and pursuits are associated with the greatest risk. Our findings have public health implications and suggest that primary and secondary cardiovascular prevention efforts are needed among law enforcement officers.

Project description:IntroductionThe Centers for Disease Control and Prevention (CDC) recently found that Asians have considerably higher biomarker levels of cadmium, lead, mercury, and arsenic than whites, blacks, Mexican Americans, and other Hispanics in the United States.ObjectiveOur goal was to further evaluate the higher metal biomarker levels among Asians.MethodsBiomarker data (blood cadmium, blood lead, blood mercury, urinary total arsenic, and urinary dimethylarsinic acic) from individuals ? 6 years of age were obtained from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). We compared geometric mean levels of these five metal biomarkers in Asians with those of four other NHANES race/ethnic groups (white, black, Mexican American, and other Hispanic), and across three Asian subgroups (Chinese, Asian Indian, and other Asian). We also evaluated associations between biomarker levels and sociodemographic, physical, dietary, and behavioral covariates across the Asian subgroups.ResultsAsians had significantly higher levels of all five metal biomarkers than other race/ethnic groups (p < 0.05), regardless of sociodemographic, physical, dietary, behavioral, or geographic characteristics. We also found variations in biomarker levels across the Asian subgroups. In general, Asian Indians had lower levels than the other two Asian subgroups, except for blood lead. The following characteristics were found to be significant predictors of several biomarker levels: sex, age, education, birthplace, smoking, and fish consumption.ConclusionsOverall, the Asian group had the highest geometric mean biomarker levels for all of the five metal variables. Furthermore, we provided evidence that significant variations in the biomarker levels are present across the Asian subgroups in the United States. Citation: Awata H, Linder S, Mitchell LE, Delclos GL. 2017. Biomarker levels of toxic metals among Asian populations in the United States: NHANES 2011-2012. Environ Health Perspect 125:306-313;?http://dx.doi.org/10.1289/EHP27.

Dataset Information

Sudden Cardiac Death Risk Distribution in the United States Population (from NHANES, 2005 to 2012).

Publications

Sudden Cardiac Death Risk Distribution in the United States Population (from NHANES, 2005 to 2012).

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