Sudden cardiac death due to genetic or congenital heart diseases is more common in male minority athletes.

According to a study published in The American Journal of Medicine, many variables have recently garnered attention among physicians when diagnosing and causes of sudden cardiac death in athletes, including race, sex, cardiac diagnosis and sport. While the incidence of sudden death as a result of genetic or congenital heart disease is not common in women, it is much more common among black men and other minorities.

Researchers used the U.S. National Registry of Sudden Death in Athletes (1980-2011to identify the epidemiology and causes of sudden cardiac death in athletes. A total 2,406 deaths were studied in athletes with a mean age of 19 ± 6 years who were competing in 29 different sports.

“Utilizing this registry, we have established that hypertrophic cardiomyopathy is the leading cause of sudden cardiac death in male athletes and is an underappreciated cause of sudden death in male African-American and minority athletes, but is a rare cause of death in female athletes,” Barry J. Maron, MD,director of the Hypertrophic Cardiomyopathy Institute Division of Cardiology at Tufts Medical Center, said in a press release.

Over the 32-year period, 89% of sudden deaths from all causes occurred in men. The mortality rate in men was eightfold higher than for women (P < .001).

The number of all-cause sudden deaths among white athletes was 62% and among black athletes and other minorities was 38%. However, the incidence of mortality was 3.2-fold higher among black athletes other minorities compared with white athletes (1 per 6,314 athlete-years vs. 1 per 20,096 athlete years; P .001). Additionally, the rate of CV death was fivefold higher among black athletes and other minorities compared with white athletes (1 per 12,778 athlete-years vs. 1 per 60,746 athlete-years; P < .001).

The researchers identified hypertrophic cardiomyopathy as the most common cause of sudden death. Hypertrophic cardiomyopathy was reported in 36% of athletes overall and accounted for 39% of sudden deaths among men compared with 11% of women (P .001). Black athletes and other minorities were more likely than white athletes to have hypertrophic cardiomyopathy (42% vs. 31%; P .001).

Congenital coronary artery anomalies, arrhythmogenic right ventricular cardiomyopathy and clinically diagnosed long QT syndrome were more common in women.

“These observations underscore the potential value of the American Heart Association/American College of Cardiology-recommended preparticipation screening in minority and other communities, particularly for the identification of hypertrophic cardiomyopathy.” – by Dave Quaile

Disclosure: Maron reports no relevant financial disclosures.

Maron BJ, et al. Am J Med. 2016;doi:10.1016/j.amjmed.2016.02.031.