More than 50% of all cardiac deaths are due to sudden cardiac death (SCD), and in the majority of individuals SCD is the first sign of coronary heart disease – this is especially true in women.  The aim of this study was to determine the degree to which adherence to a healthy lifestyle may lower the risk of SCD among women.

Using data from the Nurses’ Health Study, a prospective cohort of 81,722 US women was followed from 1984 to 2010, with lifestyle factors being assessed by means of questionnaires every 2 to 4 years.  ‘Low-risk’ lifestyle was defined as not smoking, having a BMI of less than 25, exercising for 30 minutes/day (or more), and a top 40% Mediterranean diet score.  The main outcome measure was sudden cardiac death.

Over the 26 years of follow-up, there were 321 cases of sudden cardiac death, with cases occurring at a mean age of 72 years.  All four low-risk lifestyle factors were significantly and independently associated with a lower risk of SCD.  Compared to women with 0 low-risk factors, the relative risk of SCD of women with all four was 0.08.  The proportion of SCD attributable to smoking, inactivity, being overweight, and poor diet was 81%.

Conclusions:

Women leading a healthier lifestyle are at a lower risk of SCD.  More widespread adoption of a healthy lifestyle may help to lower mortality from cardiovascular disease.

• Chiuve SE, Fung TT, Rexrode KM et al.  Adherence to a Low-Risk, Healthy Lifestyle and Risk of Sudden Cardiac Death Among Women.  JAMA 2011;306:62-69.