Trends from 1987 to 2004 in sudden death due to coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study.

BACKGROUND: Few data are available on the secular changes in sudden coronary heart disease (CHD) death in US communities.

METHODS: We examined trends in sudden CHD death from 1987 to 2004, using data from the Atherosclerosis Risk in Communities (ARIC) study. Sudden CHD deaths in residents of 4 communities aged 35 to 74 years were ascertained using multiple sources such as death certificates, informant and coroner interviews, and physician adjudications. Poisson regression was used to assess the trends for the 6 periods: 1987 to 1989, 1990 to 1992, 1993 to 1995, 1996 to 1998, 1999 to 2001, 2002 to 2004, after adjusting for demographic factors.

RESULTS: Overall, 32.6% of CHD deaths were sudden, occurring within an hour after the onset of symptoms, 63.5% of which had no prior diagnosis of CHD. For women, the rate declined by 40% (P = .059) for sudden deaths with CHD history, 27% (P = .067) for those without CHD history, and 39% (P

CONCLUSION: Although the rate of sudden CHD deaths, with and without CHD history, declined over time, the trend pattern may differ by community and gender.