Several risk factors have been identified in previous studies, such as pre-existing heart diseases, hypertension, and unhealthy lifestyles. However, the understanding of less obvious factors that could contribute to the incidence remains limited.
Identifying and addressing these modifiable factors is crucial, as they could offer new opportunities for the prevention of sudden cardiac arrest. This more holistic approach could allow the development of more effective public health strategies, aimed at mitigating the burden of this devastating condition.
IDENTIFY NEARLY 60 NON-CLINICAL RISK FACTORS ASSOCIATED
This is the goal of a new study by Fudan University, Shanghai, China, which identifies 56 non-clinical risk factors associated with sudden cardiac arrest, spanning lifestyle, physical measures, psychosocial factors, socioeconomic level, and local environment; and provides compelling evidence that improving these unfavorable factors could prevent up to 63% of sudden cardiac arrest cases.
The article, published in the ‘Canadian Journal of Cardiology’ by Elsevier, offers new insights into how lifestyle and environmental factors can contribute to prevention.
In Canada, it is estimated that there are 60,000 sudden cardiac arrests each year. A reliable and practical approach to mitigating the burden of sudden cardiac arrest involves investigating long-term modifiable risk factors and subsequently formulating preventive measures. However, significant knowledge gaps persist regarding the prevention of sudden cardiac arrest.
The lead researcher and first author of the article, Huihuan Luo, explains that all previous studies that investigated the risk factors for sudden cardiac arrest were based on hypotheses and focused on a limited number of candidate exposure factors based on previous knowledge or theoretical frameworks.
«We conducted a exposome-wide association study, which examines the relationship between a wide range of environmental exposures and health outcomes using data from the UK Biobank, followed by a Mendelian randomization to evaluate causal relationships. The study found significant associations between several modifiable factors and sudden cardiac arrest, with lifestyle changes being the most impactful in preventing cases,» he says.
40% OF SUDDEN CARDIAC ARREST CASES COULD BE PREVENTED
According to the study, removing a third of the most important risk factors (conservative elimination) could prevent 40% of sudden cardiac arrest cases; a figure that increases to 63% if the two-thirds most severe risk factors are eliminated (comprehensive elimination).
Lifestyle habits appeared to be the most significant contributors to preventing sudden cardiac arrest, accounting for 13% and 18% of sudden cardiac arrest cases with conservative and comprehensive elimination, respectively.
Researchers are surprised because among the factors they point out as protective are moderate consumption of champagne and white wine, at the same level as increased fruit intake or maintaining a positive mood, controlling weight, blood pressure, or improving education.
IS WINE, CHAMPAGNE, AND SPENDING TIME ON THE COMPUTER GOOD?
The study confirmed several factors that could be prioritized for hypothesis-based clinical trials and implementation as public health strategies, including computer usage time, champagne and/or white wine consumption, fruit intake, psychosocial stress, obesity-related factors, systolic blood pressure, and education.
The reason is that in the analysis, which recalls the well-established relationship between alcohol consumption and the risk of cardiorespiratory diseases, specific results of beverages suggested that the consumption of certain types of alcohol, such as red and white wine, could protect against sudden cardiac death, although it is inconclusive.
Likewise, it points out that while vigorous exercise can trigger an acute cardiac event, epidemiological studies have revealed a reduced risk of sudden cardiac arrest in relation to regular moderate to vigorous physical activity. However, the health benefits of exercise are not in doubt.
FIVE SURPRISING FINDINGS
Alcohol consumption: Moderate consumption of red and white wine could have a protective effect against SCA, although further investigation is requested.
Regular physical activity: Participation in moderate to vigorous physical activity was associated with a lower risk of sudden cardiac arrests.
Sleep: Both insufficient and excessive sleep duration were linked to a higher risk of sudden cardiac arrests, suggesting that unfavorable sleep patterns may contribute to the development of this condition.
Education and socioeconomic level: The study revealed that higher educational level and higher socioeconomic status could protect against sudden cardiac arrests.
RECOMMENDATIONS FOR PREVENTION
Lifestyle modification: Promoting changes in lifestyle habits is key to reducing the burden of SCA. Regular physical activity, a balanced diet, and improving sleep habits should be encouraged.
Community-level actions: Improving the local environment through air pollution management and urban planning can also reduce the risk of SCA.
Public awareness: Governments and public health authorities are recommended to launch campaigns to promote lifestyle modifications and reduce psychosocial stress.