The exact reason is unknown.Biological and social factors under study
The recent sudden cardiac arrests of college basketball player Bronny James and pro football player Damar Hamlin more than shocked the sports world and the nation. They drew attention to an alarming but little-known fact. Sudden cardiac arrest is the number one medical cause of sudden death in young athletes in the United States, and Black athletes appear to be at higher risk.
The problem is, no one knows exactly why.
In the cases of James and Hamlin, quick first aid saved their lives. Hamlin recently resumed playing football, and James plans to return to the basketball court soon. But happy endings don’t always happen, and some researchers are sounding the alarm.
“Understanding why black athletes have higher rates of sudden cardiac arrest among all athletes is a public health imperative,” said Dr. Jonathan Kim, chair of sports cardiology and associate professor of medicine at Emory University. “This is an important question and should be an urgent focus of future research.” University of Atlanta. He is also currently the Chairman of the American College of Cardiology’s Sports and Exercise Cardiology Council.
Kim, who studies health disparities, is fulfilling that role. He is among several NHLBI-supported individuals who are studying heart health conditions in athletes and others, with the goal of better understanding why sudden cardiac arrest occurs, although it is relatively rare. I am one of the researchers.
Sudden cardiac arrest occurs when the heart suddenly stops beating. If intervention is not immediate, CPR or a defibrillator is most often used, and death usually occurs within minutes. Cardiac arrest is different from a heart attack, which occurs when a blockage in an artery restricts blood flow to the heart.
“What we are seeing now is not necessarily a new trend or a new increase in the number of cases,” Kim explained. “In the general U.S. population, blacks tend to have higher rates of sudden cardiac arrest and sudden cardiac death than whites. The trend toward higher rates of black athletes reflects that disparity.” NHLBI. A 2015 funded study by researchers at the Smit Heart Institute at Cedars-Sinai in Los Angeles found that as a group, black people experience sudden cardiac arrest at twice the rate of white people. found.
Young black male college basketball players are particularly at risk.2020 survey in british medical journal The incidence of sudden cardiac arrest or death in these athletes was found to be 21 times higher than the average for high school male athletes of all races. The second highest-risk group in this study was black male college football players.
Researchers have little explanation. One of the diseases that is associated with sudden cardiac arrest in athletes is hypertrophic cardiomyopathy. This causes the heart muscle to become larger and thicker than normal. This condition can be inherited or acquired. It has an estimated prevalence of 1 in 500 in the general U.S. population and approximately 1 in 2,000 in athletes. However, Kim pointed out that the condition has not been shown to be more prevalent among black athletes.
“We also need to consider and evaluate the social and environmental determinants of health that may influence these disparities in young athletes,” Kim said.
For example, his own research found that black college football players may be at higher risk of developing a heart change called concentric left ventricular hypertrophy, or C-LVH, in which the left side of the heart becomes thicker. did. Furthermore, Kim showed that this condition was closely related to lower household income levels for black athletes compared to white athletes. More research is needed, he said.
Patrice Desvigne-Nickens, M.D., medical officer in the Division of Heart Failure and Arrhythmia in NHLBI’s Division of Cardiovascular Sciences, believes that the social determinants of health, the conditions and environments in which we are born, grow, live, and age, are influential. I agree that it is likely. important role.
“Important factors contributing to health disparities among Black athletes likely include factors such as structural racism, barriers to accessing health care, mistrust of the health care system, and underrepresentation in clinical trials.” said Desvigne-Nickens. “These problems are modifiable. Understanding and addressing them will go a long way toward preventing this life-threatening cardiac event by providing better knowledge of Black athletes’ susceptibility and risk predictors.” It could be helpful.”
Hamlin and James’ sudden cardiac arrest is providing new insight as researchers try to identify and understand the underlying cause. In Hamlin’s case, experts later confirmed a diagnosis of cordis syndrome, a rare condition that occurs after sudden blunt trauma to the chest. In James’ case, his sudden cardiac arrest is believed to have been caused by a congenital defect, according to a family spokesperson.
In response to recent incidents, some schools and medical societies are calling for improvements to cardiac safety measures in sports, including increased use of emergency action plans, enhanced cardiopulmonary resuscitation training, and increased availability and use of defibrillators. There are also growing calls for this. Despite limited data on the exact cause, some have called for increased screening and physical examinations of at-risk athletes. One group developed a registry called the Athlete Cardiac Disease Outcomes Registry (ORCCA) to monitor the clinical outcomes of athletes diagnosed with heart disease associated with sudden death.
“As with most health care disparities, I suspect there are many reasons why young Black athletes seem to have higher rates of sudden cardiac arrest and sudden death. The answer is likely multifactorial, so I’m not providing all the answers. I don’t think there’s a single study or initiative that can do it,” said Rachel Lampert, MD, a professor at Yale University School of Medicine in New Haven, Connecticut. and a researcher in the ORCCA study.
“It would be great if we could get experts thinking about this problem in the same room and discuss it in detail and come up with some approaches,” said Lampert, who received the NHLBI grant and has expertise in hypertrophic cardiomyopathy. he added. “There are many pieces to this puzzle, and we need to look at the problem from all angles.”
Editor’s note: Watch the accompanying short video on this topic: https://vpro.io/share/652d9609489958357850b0a2
