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Sudden cardiac death (SCD) is the abrupt cessation of cardiac activity leading to unresponsiveness and no signs of respiration or circulation that cannot or is not corrected. In addition to well-established risk factors which include advancing age, male sex and structural heart disease, observational data indicate that there is a wider range of psychosocial aetiological factors which have been under researched, and for which causative mechanisms remain unclear. These may include environmental stress imposed by famine, war, earthquakes and social upheaval which have been observed to coincide with transient increases in SCD.1 Community-based observational studies also indicate a potential relationship between anxiety and SCD, and there may even be a circadian and seasonal component to SCD risk.2 Social factors, including low educational attainment, life stressors, such as bereavement, unemployment and divorce, and social isolation, have also been linked to cardiovascular mortality and SCD. The role of environmental air pollution on respiratory and cardiovascular health is under increasing scrutiny, and was recorded as a cause of death in a landmark UK case in 2020 following a fatal case of acute asthma in childhood. Cigarette smoking confers a substantial risk of SCD, which …
Contributors Both authors contributed in wrting and reviewing the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.