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Int J Angiol 2021; 30(04): 271-276
DOI: 10.1055/s-0041-1729629
Original Article

Sudden Cardiac Death in the General Population: Can We Improve Risk Stratification and Prevention?

Gary L. Murray
1   Department of Cardiology, The Heart and Vascular Institute, Germantown, Tennessee
,
Joseph Colombo
2   Department of Cardiology, Physio PS, INC, Atlanta, Georgia
3   Department of Cardiology, Autonomic Dysfunction and POTS Center, Sicklersville, New Jersey
› Author Affiliations Funding None.
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Abstract

A total of 15 to 20% of deaths worldwide are sudden (within 1 hour of symptom onset). Our ability to predict and prevent sudden cardiac death (SCD) in the general population, in which 85% have no known organic heart disease (OHD) or stable OHD with left ventricular ejection fraction >40%, is limited to poor. The purpose of this commentary is to suggest a new approach to SCD in this population. Oxidative stress is a common thread in development and progression of the major cardiac diseases associated with SCD. It has a profound adverse effect upon heart rate variability (HRV), sympathetic tone (S), and parasympathetic tone (P). Recently, developed technology finally has allowed accurate measures of S and P. Using this technique, the general population can be screened, those at risk for SCD can be identified with a higher degree of success, and preventative measures instituted. For example, in 133 geriatric type 2 diabetics with S and/or P abnormalities upon screening, the potent and natural antioxidant (r)α lipoic acid reduced SCD (relative risk reduction) 43% (p = 0.0076), mean follow-up 6.31 years. Diabetes mellitus patients have high glycemic oxidative stress. Addressing oxidative stress S and P abnormalities can reduce SCD. S and P screening of the general population will be discussed.

Keywords

sudden cardiac death - prevention - oxidative stress - α lipoic acid - diabetes - ventricular fibrillation - acute myocardial infarction


Publication History

Article published online:
19 July 2021

© 2021. International College of Angiology. This article is published by Thieme.

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