Sudden cardiac death among women in the United States.

United States To the Editor: The recent article by Albert and colleagues1 is on a topic of much interest because, as noted by the authors, the rate of sudden cardiac death among middle-aged women is increasing. The authors investigated relationships between potential risk factors for cardiovascular disease and sudden death in the Nurses’ Health Study. I cannot understand why the authors failed to comment on or even discuss the potential role of medications or pharmacologically active agents that the women with sudden death may have been consuming. An increased risk of cardiac arrhythmias with noncardiac as well as cardiac drugs that prolong repolarization has been demonstrated in women both with and without cardiac disease.2–4 Although it appears that medication information may not have been routinely collected during the Nurses’ Health Study, the authors state that they reviewed medical records of all the women with sudden death, as well as reports from next of kin for the current investigation. Information on medication and nutraceutical use would be of great value in elucidating potential causes for sudden death in the women studied.