Chronic Kidney Disease Increases Sudden Cardiac Arrest Risk in Hispanic and Latino People
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Chronic kidney disease is among the strongest risk factors for sudden cardiac arrest in Hispanic and Latino people, a new study suggests.
For the study, researchers examined medical records for two groups of Hispanic and Latino adults — 295 people who experienced sudden cardiac arrest, and a control group of 590 individuals without this history. Roughly half the cardiac arrest patients had chronic kidney disease, and 20 percent had advanced cases requiring dialysis, according to study results published in the Journal of the American Heart Association.
“We were surprised by the high proportion of Hispanic or Latino people with chronic kidney disease, and especially the high number on dialysis,” said the lead study author, Kyndaron Reinier, PhD, MPH, the associate director of the center for cardiac arrest prevention at the Smidt Heart Institute at Cedars-Sinai Health System in Los Angeles, in a statement.
Compared with people who didn’t experience cardiac arrest, those who did were 7.3 times more likely to have chronic kidney disease, the study found.
“Early detection and management of chronic kidney disease may reduce sudden cardiac arrest risk among Hispanic or Latino individuals,” Dr. Reinier said. “The death rate for sudden cardiac arrest is more than 90 percent, making prediction and prevention of this condition a top priority.”
What Happens During Cardiac Arrest?
When people experience sudden cardiac arrest, all heart activity and breathing stops and they lose consciousness. Without immediate medical attention to restart the heart, such as cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED), this condition is usually fatal.
Most often, the cause of sudden cardiac arrest is an irregular heartbeat, although it can strike people who have no history of heart disease, according to the Mayo Clinic. Many risk factors for heart disease can also increase the risk of sudden cardiac arrest, including smoking, obesity, diabetes, a sedentary lifestyle, high blood pressure, or elevated cholesterol levels.
Research Details Disparities in Care
In the study, heavy drinkers were 4.5 times more likely to experience sudden cardiac arrest. A heart rhythm disorder known as atrial fibrillation was associated with a quadrupled risk of cardiac arrest, and a history of stroke or coronary artery disease were both linked to a tripled risk of cardiac arrest.
The study wasn’t a controlled experiment designed to prove whether or how chronic kidney disease might directly cause sudden cardiac arrest. But kidney disease was less common among participants who didn’t experience sudden cardiac arrest, and fewer than 1 percent of them were on dialysis.
While Hispanic and Latino individuals living in the United States are no more likely than white people to have chronic kidney disease, they are about 50 percent more likely to have end-stage renal disease that requires dialysis, according to the study.
This may be due at least in part to health disparities encountered by Hispanic people in the United States, says Joaquin Cigarroa, MD, the director of the Knight Cardiovascular Institute and a professor of medicine at Oregon Health and Sciences University in Portland, who wasn’t involved in the new study.
“Hispanics have a high prevalence of diabetes and high blood pressure along with lipid abnormalities,” Dr. Cigarroa says. “Due to social disparities including lower rates of insurance and access, individuals present later and have complications of diabetes including chronic kidney disease and higher rates of consequent dialysis.”
Prevention Is Key
Advanced kidney disease and dialysis also go hand in hand with a variety of cardiovascular problems that can play a role in cardiac arrest, including coronary artery disease, heart failure, and heart attacks, Cigarroa adds.
One limitation of the study is that most of the Hispanic and Latino participants were of Mexican descent, making it possible that results would be different for individuals from other parts of the world.
“We hope other researchers try to replicate our findings in different populations,” said the senior study author, Sumeet Chugh, MD, the director of the center for cardiac arrest prevention at the Smidt Heart Institute, in the statement. “We would like to compare risk predictors for sudden cardiac arrest in all individuals to determine whether ethnicity-specific prevention or treatment measures are needed.”
In the meantime, the best way to prevent cardiac arrest is to know your blood pressure, cholesterol levels, and blood sugar levels, Cigarroa says. The best first step for prevention is to change your diet and take medications if any of these measures are elevated, he says.
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