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Studies suggest that the underlying biological differences are probably the culprits.
Doctors have known for years that "in the United States, blacks are at greater risk than whites of dying from sudden cardiac arrest, but the reasons are unclear.
A great new study identifies what does not cause this racial disparity: differences in income, education, diet, smoking, stress, and other traditional markers of heart health.
This suggests that the underlying biological differences are probably the culprits, said lead author Rajat Deo, an associate professor at the Perelman School of Medicine at the University of Pennsylvania.
The findings, published Monday in the Journal of the American College of Cardiology, come from a six-year analysis conducted on 22,500 people with no history of cardiovascular disease. Black participants in the study were more than twice as likely as whites to die from sudden cardiac arrest, with 18 deaths per 10,000 blacks each year, compared with seven sudden cardiac deaths per 10,000 whites.
Although the exact reasons for this discrepancy remain unknown, Mr Deo said the study showed the need to act in areas with a high black population, including an increase in CPR training and the availability of automated external defibrillators.
"A combination of awareness, education, and resource allocation can help reduce the burden of sudden cardiac death in a city like Philadelphia," said Deo, a cardiac electrophysiologist.
A study conducted in 2017 by a physician at Duke University came to the same conclusion: people in predominantly black neighborhoods were less likely to have CPR or defibrillation than people living in predominantly white areas.
Another study, led by David Gaieski, a physician at Jefferson University, revealed that Philadelphia as a whole has a mediocre number of passers-by to the rescue. CPR was attempted in 10.7% of cases, less than half the rate observed in some areas. Philadelphians have used defibrillators even less often: in only 1 case per 1,000,000 between 2008 and 2012, said Gaieski, professor of emergency medicine at Jefferson College of Medicine Sidney Kimmel.
In the United States, each year, more than 350,000 people experience sudden cardiac arrest and most die, according to the American Heart Association. The condition is defined as a sudden stop of the heart, usually due to an electrical anomaly. This is not the same as a heart attack, although it may result. Sudden cardiac arrest can also result from various types of cardiomyopathy, in which the heart muscle is enlarged or abnormally thick.
To address the issue of racial disparity, Penn's Deo collaborated with researchers from the University of Alabama in Birmingham, who were already studying this issue to solve another health problem: accidents cerebrovascular diseases.
At Deo's suggestion, stroke researchers agreed that whenever a member of their study died suddenly, they would contact their loved ones to determine if the person had suffered a sudden death. cardiac origin.
With funding from the National Institutes of Health, the Alabama team recruited more than 30,000 participants. Deo and his colleagues focused on a subset of 22,500 people with no history of cardiovascular disease and followed them for a median of six years.
After calculating that blacks were twice as likely to die from sudden cardiac arrest, the team then analyzed the results to see what might explain this discrepancy. First, they discovered that the disparity existed regardless of education, income and level of health insurance.
They then analyzed a series of other factors likely to explain the difference: blood pressure, diabetes, body weight, level of physical activity, stress and consumption of alcohol or cigarettes. Taking all these factors into account, Blacks participating in the study were almost twice as likely to die of sudden cardiac arrest. This suggests that some of these factors may explain a small part of the racial disparity, but that the underlying biological differences are more to blame.
For example, previous studies have shown that blacks who die from sudden cardiac arrest are more likely to have suffered from thickening of the heart muscle, Deo said.
The main lesson is the importance of fast action, said Gaieski, Jefferson's doctor. He added that in some cases, third parties may be reluctant to administer CPR because of uncertainty. Bad idea.
"Whenever there is a question, if you think that a person has had a cardiac arrest, you should do CPR" and ask someone to look for a defibrillator, a- he declared. "Start chest compressions and call 911."
CPR is far from a guarantee of survival, but it allows oxygen to circulate until the heart can be shocked to restart or restart alone.
And the training seems to make the difference, according to another study presented earlier this month at a meeting of the American Heart Association. In states where high school students are required to learn cardiopulmonary resuscitation, the procedure is more likely to be performed and the patient survival rate is higher, the authors found.
Most states, including New Jersey, now require students to learn CPR. The Pennsylvania State Senate has adopted this requirement this year, but it is not expected to progress further by the end of the session.
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