Stroke Research & Therapy

Sudden cardiac death in the general population: Can we prevent a majority?

Fifteen-20% of deaths worldwide are sudden(within 1 hr of symptom onset).Our ability to predict and – prevent sudden cardiac death(SCD) in the general population, in which 85% have no known organic heart disease(OHD) or stable OHD with left ventricular ejection fraction(LVEF) >40%, is limited to poor. The purpose of this commentary is to suggest a new approach to SCD in this population. Oxidative stress is a common thread in development and progression of the major cardiac diseases associated with SCD. It has a profound adverse effect upon  Heart Rate Variability (HRV), Sympathetic tone (S), and parasympathetic tone (P).Recently developed technology finally has allowed accurate measures of S and P. Using this technique, the general population can be screened, those at risk for SCD can be identified with a higher degree of success, and preventative measures instituted. For example, in 133 geriatric type 2 diabetics (DM II) with S and/or P abnormalities upon screening, the potent, natural antioxidant (r)alpha lipoic acid (ALA) reduced SCD (relative risk reduction[RRR]) 43%(p=0.0076), mean follow-up(f/u) 6.31 yrs. DM patients have high glycemic oxidative stress. Addressing oxidative-stress S and P abnormalities can reduce SCD.S and P screening of the general population will be discussed.

Author(s):

Jonathan Gary L Murray

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