Sudden death from cardiac arrest among young Americans

Colin Rose, MD
2001-05-09

From the PROCOR Discussion, 3/8/01: A vision of the Future

Please see the newspaper article below about the rise of sudden death among young Americans.

Too bad Darwin isn't around to witness this. We are beginning to see natural selection at work on the fast food generation. I suppose in a
few thousand years a MacDonald's resistance gene will be selected. In the meanwhile about half the number of young Americans who died in the
Vietnam war are dying at an increasing rate every year from a preventable disease. It's not caused by bad genes or chronic infections. More bypasses and angioplasties and Ramipril will make no difference. What do ProCOR members suggest we do about it?

Colin Rose MD

Cardiac Arrests On Rise In Young

March 2, 2001

SAN ANTONIO (AP) - The death rate from cardiac arrest rose surprisingly
among young American adults in the 1990s, climbing 10 percent in men and
32 percent in women, federal officials said Thursday. Cardiac arrest is
still rare under age 35, accounting for just 1 percent of all deaths
from this cause. But experts say the newly recognized increase is
troubling and almost certainly represents a real trend and not a
statistical blip. Researchers believe a major reason for the increase
is the epidemic of obesity, along with increased smoking and drug abuse,
particularly cocaine, which can be a powerful trigger of cardiac arrest.

Doctors from the Centers for Disease Control and Prevention conducted
the first-ever survey of cardiac arrest in people ages 15 to 34. They
released the figures in San Antonio at an epidemiology conference of the
American Heart Association. Across the United States, the number of
fatal cardiac arrests in this age group rose from 2,710 in 1989 to 3,000
in 1996. In all, 23,320 young adults died, almost three-quarters of them
men.

``It's a very scary finding, and it deserves a lot of attention,'' said
Dr. Murray Mittleman of Beth Israel Deaconess Medical Center in Boston.
``If it is a behavioral factor, such as smoking or illicit drug use,
that will be very important to tease out.''

Dr. George Mensah, chief of the CDC's cardiovascular division, said that
doctors have traditionally considered cardiac arrest to be exclusively a
problem of older people. ``We need to increase awareness,'' he said.
``Dying suddenly is not just an old folks' problem. It can happen to
young people, too. Three thousand deaths are not trivial. These are
people who should not die suddenly.''

Mensah said researchers were especially disturbed by gender and racial
disparities. During the eight years, the death rate from cardiac arrest
increased three times faster in women than in men. It went up 19
percent in blacks and 14 percent in whites. The study did not break
down the increase in other racial and ethnic groups. In 1996, the last
year of the survey, the death rate for men ranged from two per 100,000
for those in their late teens to 11 per 100,000 for those in their early
30s. In women, this ranged from one to 4 per 100,000 for the two age
groups. Cardiac arrest occurs when the heart suddenly quits pumping in
an organized way, stopping blood circulation. Unless victims are
quickly revived by defibrillators, they soon die or suffer irreversible
brain damage. Although the specific triggers in the young are unclear,
doctors know that in older people, cardiac arrest often results from the
same disease process that makes the arteries clog up.

``Sudden cardiac death is a tragedy in anyone, and it is a particular
tragedy in a young person,'' said Dr. Rose Marie Robertson of Vanderbilt
University, president of the heart association. ``Clearly we don't
understand all the underlying reasons for this increase. It clearly has
happened at a time when we've seen an increase in cardiac risk
factors.''

According to federal figures, 17 percent of U.S. high school students
say they smoke cigarettes regularly, compared with 12 percent a decade
ago. Twelve percent of people in their 20s are now considered obese,
compared with 7 percent 10 years ago. Among people in their 30s,
obesity has risen from 11 percent to 19 percent. Too much weight causes
an array of ill effects that might increase the risk of cardiac arrest,
including higher cholesterol levels, high blood pressure and diabetes.

Copyright 2001 The Associated Press. All rights reserved.

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