Sudden cardiac death in the United States, 1989 to 1998

Background-Sudden cardiac death (SCD) is a major clinical and public health problem. Methods and Results-United States (US) vital statistics mortality data from 1989 to 1998 were analyzed. SCD is defined as deaths occurring out of the hospital or in the emergency room or as "dead on arrival" with an underlyin g cause of death reported as a cardiac disease (ICD-9 code 390 to 398, 402, or 404 to 429). Death rates were calculated for residents of the US aged g reater than or equal to 35 years and standardized to the 2000 US population . Of 719 456 cardiac deaths among adults aged greater than or equal to 35 y ears in 1998, 456 076 (63%) were defined as SCD. Among decedents aged 35 to 44 years, 74% of cardiac deaths were SCD. Of all SCDs in 1998, coronary he art disease (ICD-9 codes 410 to 414) was the underlying cause on 62% of dea th certificates. Death rates for SCD increased with age and were higher in men than women, although there was no difference at age greater than or equ al to 85 years. The black population had higher death rates for SCD than wh ite, American Indian/Alaska Native, or Asian/Pacific Islander populations. The Hispanic population had lower death rates for SCD than the non-Hispanic population. From 1989 to 1998, SCD, as the proportion of all cardiac death s. increased 12.4% (56.3% to 63.9%), and age-adjusted SCD rates declined 11 .7% in men and 5.8% in women. During the same time, age-specific death rate s for SCD increased 21% among women aged 35 to 44 years. Conclusions-SCD remains an important public health problem in the US. The i ncrease in death rates for SCD among younger women warrants additional inve stigation.