Temporal trends in sudden unexpected death in a general population: The Hisayama Study

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• 作者：Masaharu Nagata ; MD ; PhD^a ; ^b ; Toshiharu Ninomiya ; MD ; PhD^a ; ^b ; ^{nino@intmed2.med.kyushu-u.ac.jp} ; Yasufumi Doi ; MD ; PhD^a ; ^b ; Jun Hata ; MD ; PhD^a ; ^b ; Fumie Ikeda ; MD ; PhD^a ; ^b ; Naoko Mukai ; MD ; PhD^a ; ^b ; Kazuhiko Tsuruya ; MD ; PhD^b ; Yoshinao Oda ; MD ; PhD^c ; Takanari Kitazono ; MD ; PhD^b ; Yutaka Kiyohara ; MD ; PhD^a
• 刊名：American Heart Journal
• 出版年：2013
• 出版时间：June, 2013
• 年：2013
• 卷：165
• 期：6
• 页码：932-938.e1
• 全文大小：565 K

文摘

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Background

Studies addressing the temporal trends in the prevalence of sudden unexpected death (SUD) and its underlying causes in the general population are limited.

Methods

Among a total of 1934 residents aged ¡Ý20 years of the town of Hisayama, Japan, who died of endogenous causes of death and underwent autopsy examination (autopsy rate 78.5 % ) from 1962 to 2009, 204 were determined to be cases of SUD within 24 hours.

Results

The trend in the age- and sex-adjusted prevalence of SUD among all autopsy subjects was stable over four 12-year periods (13.1 % in 1962-1973, 13.4 % in 1974-1985, 15.0 % in 1986-1997, and 14.6 % in 1998-2009; P for trend = .80). Regarding causes of death, the prevalence of SUD from stroke significantly declined with time (8.0 % , 5.0 % , 2.3 % , and 2.1 % , respectively; P for trend < .001), whereas significant increments were observed in the prevalence of SUD from heart disease (4.0 % , 6.2 % , 8.6 % , and 9.7 % ; P for trend = .02) and from aortic aneurysm and dissection (0.2 % , 1.2 % , 2.9 % , and 2.8 % ; P for trend = .01). In particular, the prevalence of ischemic heart disease increased 3-fold from 2.1 % in 1962-1973 to 6.6 % in 1998-2009 (P = .04). Reflecting the increment of ischemic heart disease, SUD within 1 hour increased significantly from 2.5 % to 7.6 % during this period (P = .01).

Conclusions

The trend in the prevalence of SUD was stable across a half century in a general Japanese population. Despite the decrement in the prevalence of SUD from stroke, that from heart disease, especially ischemic heart disease, increased significantly with time.