Studies suggest underlying biological differences are a likely culprit. Physicians have known for years that black people in the United…
Studies suggest underlying biological differences are a likely culprit.
Physicians have known for years that black people in the United States are at higher risk than whites of dying from sudden cardiac arrest, but the reasons have been unclear.  A large new study identifies what is not causing this racial disparity, for the most part: differences in income, education, diet, smoking, stress and other traditional markers of heart health.
That suggests underlying biological differences are a likely culprit , said lead author Rajat Deo, an associate professor at the University of Pennsylvania’s Perelman School of Medicine.
The findings, published Monday in the Journal of the American College of Cardiology, came from a six-year analysis of 22,500 people with no history of cardiovascular disease. Zwarte deelnemers in de studie waren meer dan tweemaal zo waarschijnlijk als blanken voor die of plotselinge hartstilstand, bij een aantal 1
8 doden per 10.000 zwarte mensen per jaar, vergeleken met zeven plotse cardiale doden per 10.000 witte mensen.
Though the exact Deo said the study illustrates the need for action in areas with large black populations, including an increase in CPR training and the availability of automated external defibrillators.
“A combination of awareness, education, and resource allocation may help reduce the burden of sudden cardiac death in a city like Philadelphia, “said Deo, a cardiac electrophysiologist.
A 2017 study led by a Duke University physician came to a similar conclusion, finding that people in predominantly black neighborhoods were minder waarschijnlijk om te ontvangen CPR of defibrillatie dan mensen die leven in overwegend witte gebieden.
Another study, led by Jefferson University physician David Gaieski, founder dat Philadelphia als geheel heeft een slecht record van bijstanders die tot de redding komen, met CPR probeert in 10,7 procent van de gevallen, minder dan de helft van de tarief in sommige gebieden. Philadelphians used defibrillators even less often: in just 1 out of 1,000 cases from 2008 to 2012, said Gaieski, a professor of emergency medicine at Jefferson’s Sidney Kimmel Medical College.
Each year in the US, more than 350,000 people suffer a sudden cardiac arrest, and most of them died from it, according to the American Heart Association. The condition is defined as an abrupt stop of the heart, generally due to an electrical abnormality. Det er ikke det samme som en hjerteinfarkt, men det kan være en følge av en. Sudden cardiac arrest also can result from various types of cardiomyopathy, in which the heart muscle is enlarged or abnormally thick.
To look at the issue of racial disparity, Penn’s Deo collaborated with researchers at the University of Alabama at Birmingham who were already studying that question for a different health problem: strokes.
At Deo’s suggestion, the stroke researchers agreed that anytime someone in their study died suddenly, they would contact next kin to determine if the person had suffered a sudden cardiac death. 19659003] With funds from the National Institutes of Health, the Alabama team had recruited more than 30,000 participants. Deo and his colleagues focused on a subset of 22,500 people who had no history of cardiovascular disease following them for a median period of six years.
After calculating that black people were more than twice as likely to die of sudden cardiac arrest, The team analyserte derefter resultaterne for at se hvad som kunne forklare det klare.
De så analyserte en rekke faktorer som kan forklare forskellen: blodtrykk, diabetes, kroppsvekt, niveauer af motion, stress, and the use of alcohol or cigarettes. Taking all those factors into account, black people in the study remained almost twice as likely to die from sudden cardiac arrest.
For eksempel, tidligere studier har fundet at svarte mennesker som har en pludselig hjertestop, er mer sannsynlige å ha suffered from a thickening of the heart muscle, Deo said.
The main lesson is the importance of fast action, said Gaieski, the Jefferson physician. Han sa at i enkelte tilfeller kan bystandere hesitere at administrere CPR på grunn av usikkerhet. Bad idea.
“When there’s a question, if you think someone’s had a cardiac arrest, you should do CPR” and get someone to look for a defibrillator, he said. “Begin chest compressions and call 911.”
CPR is far from a guarantee of survival, but it keeps oxygen circulating until the heart can be shocked into restarting or restarts on its own.
And training seems to make a difference, according to another study presented earlier this month at an American Heart Association meeting.
Most states, including New Jersey, now require students to learn CPR. In countries where high school students are required to learn CPR, the procedure is more likely to be performed and the rate of patient survival is higher. Such a requirement was passed by the Pennsylvania state senate this year but is not expected to progress further at the end of the session.