Regional differences in incidence of sudden cardiac death in the young.

BACKGROUND Observational data on sudden cardiac death (SCD) in the young are scarce, but the SCD incidence of this study is to examine regional differences in SCD incidence within a population among young individuals (<40 years) and to assess whether regional incidences are associated with socio-economic status (SES ). METHODS SCD cases aged <40 years were identified in 12 provinces of the Netherlands by using death certificates recorded by Statistics Netherlands during 1996-2006. Regional incidence estimates were standardised for age to the Dutch population and assessed for two age categories; 1-29 years and 30-39 years. Regional SCD incidence was related to regional SES with a Spearman correlation coefficient. RESULTS The nationwide incidence of SCD at ages 1 to 40 years was 1.6 (95% CI 1.5 to 1.7) per 100,000 person-years and the incidence increased substantially after 30 years of age. Significant differences in regional incidences were assessed for both age categories (1-29 and 30-39 years). Although in the population aged 1-29 years significant differences were found in the SCD incidence between regions, no relation could be found with SES . In men aged 30-39 years, the incidence of SCD was inversely related to SES ; a low socio-economic status was associated with a relatively high incidence of SCD. CONCLUSION Between regions, statistically significant differences in SCD incidence exist in young individuals. The nationwide incidence of SCD increased substantially after 30 years of age and was inversely related to SES in men aged 30-39 years.