New Risk Factor For Sudden Death

PARIS, FRANCE. Sudden cardiac death is a common occurrence in industrialized countries. There is evidence that a high level of free fatty acids in the blood plasma is an independent risk factor for ventricular arrhythmias and sudden death in people who have suffered a heart attack. Medical researchers at the University of Paris now report that a high level of circulating free fatty acids (non-esterified) is also a potent risk factor for sudden death in men without cardiovascular disease.

The study involved 5250 men, aged 42 to 53 years at the start of the study in 1967-72. All participants were free of cardiovascular disease at the time of entry. The men were followed for an average of 22 years during which 1601 deaths occurred – 91 of them were classified as sudden cardiac deaths and 145 as fatal heart attacks. Analysis of test data showed that the level of free fatty acids circulating in the blood plasma is a potent risk factor for sudden death. Men with a high level had a 70 percent higher risk than did men with a low level. Surprisingly, high fatty acid levels were not a risk factor for fatal heart attack. Other prominent risk factors for sudden death were parental sudden death, parental heart attack, smoking, high systolic blood pressure, and high body mass index (obesity). High cholesterol levels increased the risk of sudden death by a relatively modest 18 percent.

The researchers and Dr. Alexander Leaf, MD of the Harvard Medical School point out that not all fatty acids are detrimental. There is ample evidence that the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the main components of fish oil are actually highly protective against sudden cardiac death. Dr. Leaf believes that it is the omega-6 fatty acids found in vegetable oils (corn, safflower, sunflower, and peanut) that are responsible for initiating the arrhythmias leading to sudden death. Fish oils, on the other hand, exert a protective effect in amounts as low as 600-1000 mg/day (EPA+DHA). Dr. Leaf points out that government agencies and heart associations have long been advocating an increased intake of polyunsaturated fatty acids without making any distinction between omega-6 essential fatty acids which appear to promote sudden death and omega-3 fatty acids (EPA and DHA) which prevent it.

References:
Jouven, Xavier, et al. Circulating nonesterified fatty acid level as a predictive risk factor for sudden death in the population. Circulation, Vol. 104, August 14, 2001, pp. 756-61.

Leaf, Alexander. Plasma nonesterified fatty acid concentration as a risk factor for sudden cardiac death: the Paris prospective study. Circulation, Vol. 104, August 14, 2001, pp. 744-45 (editorial).

*These statements have not been evaluated by the Food and Drug Administration.

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