Date: April 7, 2008

Journal: Hypertension

Journal citation: Hypertension. 2008;51:1-5

Read the original article:  http://hyper.ahajournals.org/cgi/reprint/51/6/1578

Summary: A study of 2,763 postmenopausal women found that women whose kidneys do not work well and who have heart disease are at increased risk of sudden cardiac death, in which the rhythmic beating of the heart becomes disrupted and suddenly stops.

Why it’s important: “Sudden cardiac death is an important public health problem, but it is poorly understood and understudied, especially in women,” said lead author Rajat Deo, M.D., a fellow at Johns Hopkins University Medical Center in Baltimore. Sudden cardiac death has increased over time. Previous studies have shown that coronary heart disease and advanced kidney failure are important predictors of sudden cardiac death. However, few studies have looked at the role of kidney disease as a predictor of sudden cardiac death.

What’s already known: Severe underlying heart problems such as coronary heart disease are the most important predictors of sudden cardiac death. At least one study has suggested that even risk factors for coronary heart disease are predictors of sudden cardiac death.  Additionally, the U.S. Renal Data System has reported that about 22 percent of patients with severe, advanced kidney disease die from sudden cardiac death, with older patients more at risk. Finally, although two studies have shown a correlation between chronic kidney disease and sudden cardiac death in patients with advanced heart failure, these studies did not determine whether kidney disease was a predictor of sudden cardiac death or merely a marker of the severity of heart failure.

How this study was done: Using data from the Heart and Estrogen Replacement Study, which gathered data on heart problems among 2,763 postmenopausal women with documented coronary heart disease who were receiving hormone replacement therapy, Dr. Deo and colleagues examined the association between kidney problems and sudden cardiac death in these women. All of the women were below age 80, with an average age of 67. 

What was found: Of the 2,763 women in the study, 136 died of sudden cardiac death during the study’s 6.8-year follow-up period. The risk of sudden cardiac death increased with the severity of kidney disease, from a rate of 0.5 percent per year in those with moderate kidney disease to 1.7 percent per year in those with severe kidney disease. “We found a strong, independent association between kidney function and sudden cardiac death in a group of women with coronary heart disease who were not on dialysis and had less-sick hearts than patients in previous studies. We already know that patients with kidney disease are at greater risk of heart attack, heart failure and stroke. This study extends that concern to sudden cardiac death and supports previous recommendations that people with kidney disease be monitored aggressively for cardiac risk factors,” Dr. Deo said.

The bottom line: Women diagnosed with coronary heart disease should also be tested, and treated if necessary, for kidney disease, because the presence of both conditions raises the risk of sudden cardiac death.



This content is reviewed regularly. Last updated 06/24/08.