The frequency of sudden cardiac deaths caused by ischemic heart disease is lower in women than in men

Researchers at the University of Oulu have published new information on sudden cardiac deaths in women.

Ischemic heart disease is the most common cause of sudden cardiac deaths in both women and men. University of Oulu's cardiology research team reported that women were more likely to have non-ischemic cause of a sudden cardiac death, and primary myocardial fibrosis occurs more often in women than in men. Their study also revealed that sudden cardiac deaths occur at much older age in women than in men.

One third of the women in the study who had an electrocardiogram, or ECG, taken before death, had a normal ECG result. The researchers were surprised by the prevalence of signs of primary myocardial fibrosis in women, as traditionally this change is more commonly seen in men's ECGs.

In Western countries, cardiovascular diseases are the most common cause of death. Half of cardiac deaths occur suddenly, and in half of these cases there was no prior knowledge of heart disease. Previous studies have focused on men's sudden cardiac deaths because most of the victims are men. The proportion of women in previous studies has been so small that it has been difficult to generalise the results.

The proportion of sudden deaths associated with ischemic heart disease in women has declined over the past 20 years. The researchers hope that doctors will pay attention to the development of cardiovascular diseases in female patients. The major risk factors for myocardial changes are high blood pressure and obesity. Monitoring changes in the ECG can help identify heart disease, so attention must be paid to on-going monitoring and follow-up treatment of all patients.

The Fingesture research is unique thanks to Finnish law. According to the law, when a sudden death occurs, and the cause of death is unknown, a forensic autopsy must be performed. The cardiology research team at the University of Oulu analysed 20 years of autopsy data on sudden cardiovascular deaths. The sample covers 5,869 deceased people, of whom 1,238 were women. Fingesture is the largest study of women’s sudden cardiac deaths to date.

An article on women’s sudden cardiac deaths was published in Circulation magazine’s Go Red for Women issue that focused on women’s heart diseases. Circulation is the most reputable scientific journal published in the US in the field of cardiovascular diseases. 

Article: Haukilahti MAE, Holmström L, Vähätalo J, Kenttä T, Tikkanen J, Pakanen L, Kortelainen M-L, Perkiömäki J, Huikuri H, Myerburg RJ, Junttila MJ. Sudden Cardiac Death in Women: Causes of Death, Autopsy Findings and Electrocardiographic Risk Markers. Circulation. 2019 Feb 19;139(8):1012-1021. Link to the article.

Additional information:

Professor Juhani Junttila
Medical Research Center Oulu
Oulu University Hospital and University of Oulu

Read more:

Rare genetic flaws explain sudden cardiac-based deaths of young natives of Northern Finland

Fatal fibrosis as a matter of heart

Last updated: 27.2.2019