Birthplace predicts risk for prehospital sudden cardiac death in middle-aged men who migrated to metropolitan area: The Helsinki Sudden Death Study.

Abstract:

BACKGROUND:Eastern-born male Finns, irrespective of their place of residence, have high mortality from coronary heart disease (CHD), and half of such deaths are sudden. AIM:To study whether eastern birthplace alone or combined with life-style factors predicts risk for prehospital sudden cardiac death (SCD) in the new (west) low-mortality area of residence. METHOD:Prospective case-control autopsy study of all (700) out-of-hospital deaths of men aged 35-69 years in metropolitan Helsinki during 1981-82 and 1991-92. Data on CHD risk factors were obtained for 405, of whom 149 died of SCD (cases) and 256 of other causes (controls). RESULTS:A birthplace-by-age interaction with SCD (P=0.024) and with myocardial infarction (P=0.005) appeared. Men < or =54 years born in the east were more often victims of SCD (odds ratio 2.99, 95% confidence interval 1.38-6.49, P=0.006) than were men born in the west, independently of CHD risk factors. SCD was predicted also by alcohol consumption, age, smoking, and hypertension. Amongst older (>54 years) men no association with birthplace was any longer evident, but alcohol and socio-economic status predicted SCD. CONCLUSIONS:Birthplace-based risk for SCD suggests the contribution of early life environment or genetic east-west differences, reflecting Finns' two-phase settlement history.

journal_name

Ann Med

journal_title

Annals of medicine

authors

Tyynela P,Goebeler S,Ilveskoski E,Mikkelsson J,Perola M,Loytonen M,Karhunen PJ

doi

10.1080/07853890802258753

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

57-65

issue

1

eissn

0785-3890

issn

1365-2060

pii

794878509

journal_volume

41

pub_type

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