It arrives without warning, unexpectedly and in most cases with a fulminant cardiac origin that leaves patients on the ground in a few seconds and without the ability to respond. These are some of the characteristics that the sudden deathwhich has always been one of the biggest challenges for emergency medicine and that we must increasingly take into account because cases do not stop increasing. And especially in Spain.
A new trend. A large study recently published in the journal The Lancent has put figures to this silent reality, pointing out that mortality records in the last decade have increased by 30% in Europe, and the trend in Spain exceeds the European average.
How it has been seen. To understand the magnitude of this finding, we must look at the methodology that the research team has followed, which has taken as a source of data from the WHO that come from 26 European countries between 2010 and 2020. In this period, more than 53 million deaths were recorded from many different causes, and of these 2,583,559 were classified as sudden deaths.
It is not a minor figure, since this means that almost 5% of the total deaths in that decade fall into this category. And if we look back, we observe an average annual increase of 2.9% in Europe, although if we focus on Spain, this increase rises to 3.3%.
It’s not COVID. Seeing that the study ends in 2020 and automatically blaming Covid and the vaccines that were administered is something that may be an idea that many have in their heads, but the truth is that it has nothing to do with it, since the upward trend had already been consolidated since 2013.
Which is the culprit. There are several hypotheses on the table here, one of them being the aging of the population, which is much more vulnerable to fatal cardiovascular events. But age is not the main problem, since cardiovascular risk is conferred by having a poor lifestyle that includes a sedentary lifestyle, obesity, hypertension or diabetes, which continue to be silent pandemics that prepare the ground for heart failure.
It is also important to highlight that the difference between various countries depends on the effectiveness of health systems, ambulance response times and, above all, the availability of defibrillators (AED) and CPR training of the general population. The latter is something in which Spain is not as aware as in other European countries, where a good part of the population knows how to act in the event of cardiac arrest if it occurs in the middle of the street.
Causes depending on age. In the case of the under 35 years oldthe cause is usually a genetic or structural failure that has not been previously detected, predominating electrical alterations of the heart such as the famous Brugada syndrome. The problem is that many times the patient does not present symptoms until the onset of sudden cardiac arrest, having already seen cases in our country in very young people who, for example, They play soccer and suddenly fall on the field.
In people over 35 years of age the origin changes and here lifestyle and wear and tear prevail, with acute myocardial infarction causing the vast majority of cardiorespiratory arrests.
The Spanish context. The data provided by The Lancent study fit perfectly with the demographic and health puzzle of our country, since if we go to the INE we see that heart diseases (along with oncological diseases) are responsible for half of the deaths in Spain.
And although the INE points out that in 2024 deaths from circulatory diseases decreased by 2.4% globally, entities such as the Spanish Society of Epidemiology and Cardioalianza remember an uncomfortable truth: Ischemic heart diseases continue to be the leading single cause of death in Spain.
How to improve. The European study does not seek to create alarmism, but rather to light an emergency beacon in terms of public health. Stopping this 30% increase does not involve a magic pill, but rather a dual approach: improving early diagnosis in young people with a family history and, above all, filling our streets with defibrillators and citizens who know how to do cardiac massage.
And, in absolute terms, cardiorespiratory arrest is a time-dependent process, meaning that every minute that passes without the patient receiving assistance translates into 10% less chance for your heart to beat again. This makes in 10 minutes It is almost impossible for a patient who has suffered an arrest and who does not receive CPR to come back to life, and this should make us aware of how important it is to know the basics of CPR, since it can truly save many lives.
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