title: Declining incidence of sudden cardiac death from 1990-2010 in a general middle-aged and elderly population: The Rotterdam Study.
abstract: BACKGROUND
  Although sudden cardiac death (SCD) is relatively common, contemporary data on its incidence are lacking.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the current incidence of SCD and its trend over the past 2 decades in a general middle-aged and elderly population.
  
  
  METHODS
  This study was performed within the Rotterdam Study, a prospective population-based cohort study of persons aged 45 years and older. Age-standardized incidence rates of SCD were calculated. To study trends in incidence, we compared 2 subcohorts within the total study population, 1 followed from 1990-2000 and the other from 2001-2010.
  
  
  RESULTS
  From 1990-2010, 5512 of 14,628 participants died, of whom 583 (4.0%) were classified as SCD. The overall incidence was 4.2 per 1000 person-years. The incidence was higher in men (5.2 per 1000 person-years) than in women (3.6 per 1000 person-years). Age-adjusted hazard ratio (HR) 1.84 (95% confidence [CI] 1.56-2.17) and risk of SCD increased with age (HR 1.10 per year; 95% CI 1.09-1.11). The incidence rate from 1990-2000 was 4.7 per 1000 person-years vs 2.1 per 1000 person-years from 2001-2010 (age- and sex-adjusted HR of SCD 0.60, 95% CI 0.44-0.80). To check for cohort effects, we also analyzed the incidence of total mortality and found an age- and sex-adjusted HR of total mortality of 0.82 (95% CI 0.75-0.90) for the second compared to the first subcohort, which was significantly higher than the decline in SCD incidence.
  
  
  CONCLUSIONS
  We found an incidence of SCD of 4.2 per 1000 person-years. The incidence decreased from 1990-2010, a period during which the diagnosis and treatment of heart disease greatly improved.
authors.affiliation: Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Maartje N
authors.initials: MN
authors.lastname: Niemeijer
authors.affiliation: Department of Medical Informatics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Marten E
authors.initials: ME
authors.lastname: van den Berg
authors.affiliation: Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Cardiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Maarten J G
authors.initials: MJ
authors.lastname: Leening
authors.affiliation: Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of Cardiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Deckers
authors.affiliation: Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Heeringa
authors.affiliation: Department of Medical Informatics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Rijnbeek
authors.affiliation: Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands; Inspectorate of Health Care, The Hague, the Netherlands. Electronic address: b.stricker@erasmusmc.nl.
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
authors.affiliation: Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: Eijgelsheim
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012621:Seasons; D012737:Sex Factors; D013997:Time Factors
keywords: Cardiovascular disease; Epidemiology; Incidence; Mortality; Population-based study; Sudden cardiac death; Time trends