Women at Increased Risk of Fatal, Nighttime Cardiac Arrest: Study

Washington, February 7: Women are at a higher risk than men to suffer sudden death due to cardiac arrest during nighttime hours, suggested a new study. The findings were published in the journal 'Heart Rhythm'. The study, led by the Center for Cardiac Arrest Prevention in the Smidt Heart Institute, has found for the first time that during nighttime hours, women are more likely than men to suffer sudden death due to cardiac arrest.

"Dying suddenly during nighttime hours is a perplexing and devastating phenomenon," said Sumeet Chugh, MD, senior author of the study and director of the Center for Cardiac Arrest Prevention. "We were surprised to discover that being female is an independent predictor of these events," added Chugh. Could You Suffer from Cardiac Arrest? Read to Know the Risk Factors.

Medical experts are mystified, Chugh said, because, during these late hours, most patients are in a resting state, with reduced metabolism, heart rate, and blood pressure. Sudden cardiac arrest-also called sudden cardiac death-is an electrical disturbance of the heart rhythm that causes the heart to stop beating. People often confuse sudden cardiac arrest with a heart attack.

However, a heart attack is caused by a buildup of cholesterol plaque that creates a blockage in the coronary arteries. And unlike a heart attack, when most have symptoms, sudden cardiac death can present in the absence of warning signs.

Another major difference: Most people survive heart attacks, with only 10 per cent of patients surviving out-of-hospital cardiac arrest. Of the approximately 350,000 people affected by the condition each year in the U.S., roughly 17 per cent to 41 per cent of cases occur during the nighttime hours of 10 pm to 6 am.

In the study, Chugh and his team of investigators looked at records of 4,126 patients, with 3,208 daytime cases of sudden cardiac arrest and 918 nighttime cases. Compared with daytime cases, patients who suffered from nighttime cardiac arrest were more likely to be female.

While further work is needed, the researchers suggest there may be a respiratory component causing this increased risk at night for women.

Chugh's research also showed:

1. 25.4 per cent of females studied suffered cardiac arrest at night versus 20.6 per cent of their male counterparts.

2. The prevalence of lung disease was significantly higher in those who had a cardiac arrest at night compared with those who had a cardiac arrest during the daytime.

3. Those who had cardiac arrests in the nighttime had a higher prevalence of prior or current smoking history.

"The prevalence of chronic obstructive lung disease and asthma were found to be significantly higher in sudden cardiac arrest cases at night compared with daytime cases, regardless of gender," said Chugh, also the Pauline and Harold Price Chair in Cardiac Electrophysiology Research.

"Brain-affecting medications, some of which have the potential to suppress breathing, were also found to have a significantly greater usage in nighttime compared to daytime cardiac arrest," added Chugh.

Based on these findings, this research report suggested that prescribing physicians may wish to be cautious when recommending brain-affecting medications, for example, sedatives and drugs prescribed for pain and depression management, to high-risk patients, especially women.

"This important research may better guide physicians and the broader medical community to making more sound, science-backed recommendations in treating this difficult condition," said Christine Albert, MD, MPH, chair of the Department of Cardiology in the Smidt Heart Institute and the Lee and Harold Kapelovitz Distringuished Chair in Cardiology.

"It is also a necessary continuation of sex-based research defining much of the field of cardiology," concluded Albert.

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