title: Contribution of sudden cardiac death to total mortality in India - a population based study.
abstract: BACKGROUND
  Epidemiology of sudden cardiac death (SCD) in India is understudied.
  
  
  METHODS
  We assessed proportion of SCD among total mortality in a population in Southern India using a staged, questionnaire-based kindred-wide approach. Detailed questionnaires (DQs) were completed by medical trainees from 8 medical colleges. Preliminary questionnaires evaluated total deaths in the kindred of a respondent. Deaths due to obvious non-cardiac causes were excluded. DQs were completed for the remaining deaths and categorized using a three-member adjudication system.
  
  
  RESULTS
  A total population of 22,724 was evaluated by 478 respondents, (278 M and 200 F). Out of a total of 2185 deaths, 1691 (77.4%) were recallable. A total of 173 (10.3%; 128 M and 45 F; mean age - 60.8 ± 14 years) deaths were adjudicated as SCD. Of these, 82 (47.3%) were ≤ 60 years of age. Prior MI, LV dysfunction and prior aborted SCD were found in 33.5%, 22.5% and 5.7% respectively. Coronary artery disease (CAD) was observed in 66 (38%) and acute myocardial infarction documented in 30 (17%). At least 1 of 3 CAD risk factors - hypertension, diabetes, or smoking was observed in 80.6%. Proportion of subjects with at least one risk factor for CAD were similar in the age groups above and below 50 years (67.6% vs. 81.7%, p=0.065).
  
  
  CONCLUSIONS
  SCD contributed to 10.3% of overall mortality in this population from Southern India. On an average, SCD cases were 5-8 years younger compared to populations reported in the western hemisphere, with a high prevalence of major risk factors for CAD.
authors.affiliation: CARE Hospitals Hyderabad, India. hygriv@hotmail.com
authors.forename: B Hygriv
authors.initials: BH
authors.lastname: Rao
authors.forename: B K S
authors.initials: BK
authors.lastname: Sastry
authors.forename: Sumeet S
authors.initials: SS
authors.lastname: Chugh
authors.forename: Sharada
authors.initials: S
authors.lastname: Kalavakolanu
authors.forename: Johann
authors.initials: J
authors.lastname: Christopher
authors.forename: Deepika
authors.initials: D
authors.lastname: Shangula
authors.forename: Radhika
authors.initials: R
authors.lastname: Korabathina
authors.forename: P Krishnam
authors.initials: PK
authors.lastname: Raju
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D003906:Developing Countries / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000401:mortality; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000401:mortality; D011795:Surveys and Questionnaires