Monday , March 8 2021

Women at higher risk of fatal, nocturnal heart failure

Newswise – LOS ANGELES (January 20, 2021) – New research from the Heart Conception Prevention Center at the Smidt Heart Institute in Cedars-Sinai has found for the first time that women are more likely than men to suffer sudden cardiac death at night. opposition. The findings were published in the journal yesterday Heart beat.

“Sudden death at night is a disturbing and devastating phenomenon,” said Sumeet Chugh, MD, lead author of the study and director of the Center for Cardiac Prevention. “We were surprised to find that being a woman is an independent predictor of these events.”

Medical experts are mysterious, says Chugh, because during these delayed hours, most patients are at rest, with reduced metabolism, heart rate and blood pressure.

Sudden cardiac arrest – also called sudden cardiac death – is an electrical disturbance in 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 an accumulation of cholesterol plaque that clogs the coronary arteries. And unlike a heart attack, when most have symptoms, sudden cardiac death can occur in the absence of warning signs.

Another important difference: Most people survive heart attacks, with only 10% of patients surviving heart attack out of hospital.

Of the approximately 350,000 people affected by the condition each year in the U.S., about 17% to 41% of cases occur at night from 10 p.m. until 6 a.m.

In the study, Chugh and his team looked at records of 4,126 patients, with 3,208 cases of daytime cardiac arrest and 918 cases of nighttime. Compared to daytime cases, patients with nocturnal cardiac arrest were more likely to be women.

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

Chugh’s research also shows:

  • 25.4% of the women studied suffered heart failure at night compared to 20.6% of their men.
  • The prevalence of lung disease was significantly higher in those who had heart failure at night compared to those who had heart failure during the day.
  • Those who had heart attacks during the night had a higher prevalence of previous or current smoking history.

“The prevalence of chronic obstructive pulmonary disease and asthma has been found to be significantly higher in cases of sudden cardiac arrest at night compared to cases during the day, regardless of gender,” said Chugh, also President Pauline and Harold in Cardio Electrophysiology. “Drugs that affect the brain, some of which have the ability to suppress respiration, have also been found to be significantly more used at night compared to cardiac arrest during the day.”

Based on these findings, this research report shows that prescribing physicians may want to be careful when prescribing drugs that affect the brain, for example, sedatives and medications prescribed to manage pain and depression, in high-risk patients. , especially in women.

“This important research can better guide physicians and the wider medical community to make healthier, scientifically sound recommendations for treating this difficult condition,” said Christine Albert, MD, MPH, Chair of Cardiology at the Smidt Heart Institute and Lee and Harold Kapelovich were distinguished chair in Cardiology. “It is also a necessary continuation of gender-based research that determines much of the cardiology sector.”

For two decades, Chugh led the Oregon Sudden Unexpected Death Study, a unique partnership with some 1 million residents of the Portland, Oregon subway area, and their caregivers – first responders, hospital systems and the medical network of examiners. Chugh also heads the Ventura Prediction study of Sudden Death in Multi-Ethnic Communities, based in Ventura, California, a similar community partnership with approximately 850,000 residents, first responders, medical examiners and Ventura County hospital systems.

Read more from the Cedars-Sinai Blog: Heart Rhythm Revelations

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