AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Quantifying the Impact of Age on Out-of-Hospital Cardiac Arrest Risk in Women
By Khosla S, Kotini-Shah P, Froelich E et al.
Background: While previous studies have reported an increase in heart disease and cardiovascular disease in women with age, studies that specifically examine out-of-hospital cardiac arrest (OHCA) have been limited. The aim of this study was to assess the impact of age on OHCA risk in women, and compare it to men. Methods: We analyzed non-traumatic OHCA cases reported to the Cardiac Arrest Registry to Enhance Survival (CARES) and served by Emergency Medical Services (EMS) in Illinois from 2018-2025. Only cases with presumed cardiac etiology and in the age group of 21 and above were included. Analytic sample consisted of 12,157 women and 19,359 men. Age was divided into deciles (21-30, 31-40, 41-50, 51-60, 61-70, and 71+). We assessed the distribution of cases by age group, and by the life stages/stages of menopause transition in women, and assessed trends. While we did not have menstruation data, based on age, women 21-39 years were categorized as pre-menopause, and 40-50 as perimenopause. Results: By each decile of age, there was an incremental increase in the risk in women with 21-30 years age group contributing only 1.8% of the cases, which jumped to 4.1% in 31-40 years age group, and 8% in the 41-50 age group, and continued to rise to 49.7% in the 71+ age group (slope=8.6%, p=0.014). An increase was also noticed in men, from 2.1% in 21-30 years age group, to 36.4% in 71+ (slope=6.9%, p=0.0003) but the increase among women was more drastic (Figure). From 61-70 year to 71+ age group specifically in women there was a 122.9% increase in proportion of cases while in men the increase was by 40%. Second largest jump in the proportion was observed in women and men from 21-30 to 31-40, where in women the proportion increases by 127% and in men by 148%. When analyzed by life stages, 8.8% of the OHCA in women were in perimenopause age group compared to 5.2% in pre-menopause. Hispanic women start out with a higher proportion of cases in the pre-menopause phase (7.2% vs. 6% in Black, 4.2% in White, and 2.6% in Other, p<0.001), and maintain a higher proportion in perimenopause (10.8% vs. 10.4% Black, 6.8% in White, and 6% in Other, p<0.001). Conclusion: The risk of OHCA depends on age and life stage, but the increase in risk in women is more drastic. It perhaps is not the effect of age alone but tied with the changes in menstrual phases and transition that need to be studied further.