Healthy Lifestyle Factors, Cardiovascular Comorbidities, and the Risk of Sudden Cardiac Arrest: A Case-Control Study in Korea

Abstract

Aims: We investigated the risks and benefits of healthy lifestyle factors and cardiovascular comorbidities for sudden cardiac arrest (SCA) in the Korean population.

Methods: A case-control study, including patients with SCA aged 20-79 years and community-based 1:2 matched controls, was conducted from September 2017 to December 2020. All participants completed a structured questionnaire. Using multivariable logistic regression analysis, we assessed cardiovascular comorbidities (diabetes, hypertension, dyslipidaemia, myocardial infarction, congestive heart failure, arrhythmia, and stroke) and healthy lifestyle habits (average red meat consumption [≤1/day], average fish consumption [≤1/day], average fruit consumption [>1/day], average vegetable consumption [>1/day], current smoking, regular exercise [≥1/week], and sleep duration [6-8 hours/day]) as risk factors for SCA.

Results: A total of 949 cases and 1,731 controls were enrolled. On adjusted analysis, cardiovascular comorbidities, except dyslipidaemia, were associated with an increased risk of SCA, whereas all healthy lifestyle habits were associated with a decreased risk. Relative to patients in the 0-2 healthy lifestyle habits group, the AOR for SCA was 0.25 in patients with 3 healthy lifestyle habits (95% CI: 0.16-0.40), 0.08 in patients with 4 healthy lifestyle habits (95% CI: 0.05-0.13), and 0.04 in patients over 5 healthy lifestyle habits (95% CI: 0.03-0.06). When the number of healthy lifestyle habits was analysed as a continuous variable, each additional habit was associated with a significant decrease in the likelihood of SCA (AOR: 0.41, 95% CI: 0.36-0.46).

Conclusion: The increased risk of SCA by cardiovascular comorbidities could be significantly reduced with healthy lifestyle habits.

Note:
Trial Registration Details: This study is registered at ClinicalTrials.gov (NCT03700203).

Funding Information: This work was supported by the Korea Disease Control and Prevention Agency (Grant No: 2017NE3300600, 2017E3300601, 2019P330800).

Declaration of Interests: The authors declare that there is no conflict of interest.

Ethics Approval Statement: The study was approved by the ethics committees in all participating centres. All participants or their proxy provided written informed consent before taking part in the study and he study complied with the tenets of the Declaration of Helsinki.

Keywords: cardiac arrest, risk factors, primary prevention, case-control studies