More than half of sudden cardiac death (SCD) in women occurs in the absence of diagnosed coronary heart disease, and most women with heart disease don't have the same quantifiable risk factors that would make a man an appropriate candidate for an implantable cardioverter-defibrillator. Seeking to determine whether modifying certain lifestyle factors might serve to lower the risk of SCD in women, researchers examined data from 81,722 women in the Nurses' Health Study to determine the association between adherence to a healthful lifestyle and the risk of SCD.
The lifestyle factors assessed were current smoking status, physical activity, diet, and weight. A low-risk lifestyle was defined as not currently smoking, engaging in moderate-to-vigorous exercise for at least 30 minutes per day, having a body mass index between 21 and 25 kg/m2, and adhering to the "alternate Mediterranean-style" diet (large amounts of vegetables, fruits, whole grains, legumes, omega-3 fatty acids, nuts, and fish; a high ratio of monounsaturated to saturated fat; moderate amounts of alcohol; and small amounts of red and processed meat).
Over 26 years of follow-up, 321 SCDs occurred. Women in the low-risk column for all four lifestyle factors had a 92% lower risk of SCD than women practicing none of the four healthful lifestyle behaviors. Had all of the women been in the low-risk group, the authors estimate, 81% of SCDs might have been avoided. The authors also estimate that 79% of SCD in women without clinically diagnosed heart disease can be attributed to unhealthful lifestyle practices.-WK
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