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Friday, Aug. 31, 2012

Heart ailments spiked after 3/11

Bloomberg

The great East Japan Earthquake spurred an increase in heart-related ailments and pneumonia, according to a study.

The weekly figures for heart failure, the inability of the muscle to pump enough blood around the body, and pneumonia jumped soon after the earthquake, according to Japanese researchers who presented their findings this week at the European Society of Cardiology meeting in Munich.

The phenomena were sustained for more than six weeks after the quake and tsunami, compared with the previous three years, they said.

"The occurrence of heart failure and pneumonia significantly increased, then gradually went down to the previous level, though pneumonia took almost three months to go down," Hiroaki Shimokawa, the lead researcher, told journalists in Munich. Cases of stroke, cardiopulmonary arrest and acute coronary syndrome, or symptoms of a blocked coronary artery such as a heart attack, also increased, Shimokawa said.

The findings add to the toll the natural disaster has had on the nation's health. Japan, once ranked the No. 1 country for longevity for women and near the top for men, has fallen to sixth for women and eighth or ninth for men following the March 11, 2011, disasters, said Shimokawa, a cardiologist at Tohoku University Graduate School of Medicine in Sendai.

Almost 19,000 lives were lost mainly in the monster tsunami and some 390,000 homes were destroyed, as well as pharmacies and hospitals, the researchers said. Suicides also rose, the government has reported.

Shimokawa and his colleagues analyzed more than 120,000 ambulance transport records for the weeks before and after the earthquake. They also found that people's blood pressure rose significantly.

When an aftershock of magnitude 7.0 hit April 7, 2011, there was another jump in cases of stroke and cardiopulmonary arrest, the study found.

"Taken together, we consider that the discontinuation of drugs, activated sympathetic nervous system, rising blood pressure, and the increased occurrence of tachyarrhythmia and infections were all involved in the increased occurrence of cardiovascular events after the great earthquake," Shimokawa said in a statement.

A spike in acute coronary syndrome would be expected following such a catastrophic event, because of an increase in stress hormones, said Spencer King, a professor emeritus at Emory University in Atlanta.

Stress can prompt fatty deposits inside blood vessels to rupture, King, a past president of the american College of Cardiology, said in an interview in Munich. That could lead to clots that cause heart attacks and strokes.

While a short-term increase in cases of cardiovascular illnesses has been reported with previous earthquakes, the new study is the first to examine the longer-term effects on heart health, the researchers said. The data also provide the first evidence that the incidence of heart failure rose over a long period after the disaster, they said.

Patients who stop taking their hypertension medications, for whatever reason, may develop heart failure, said Mariell Jessup, president-elect of the American Heart Association. An irregular heartbeat known as atrial fibrillation might also lead to heart failure, Jessup said.

Symptoms include breathlessness and tiredness, and don't usually prompt immediate medical attention in a crisis such as an earthquake, she said.

"If you're looking for heart attacks, and someone says, 'Oh, I'm short of breath,' that might not jump out," Jessup said in Munich.

In addition to trauma preparations, people organizing disaster drills may want to incorporate ways to mobilize heart-care specialists to address cardiovascular illnesses, she said.

The Japanese research doesn't indicate whether the people who experienced heart ailments already had cardiovascular disease, said Donna Arnett, the president of the American Heart Association.

"Everyone should be aware of the signs and symptoms of heart disease and stroke, and seek treatment" if those signs appear, Arnett said in Munich. "Once you have a condition, you should work toward improving everything you can control: diet, physical activity, not smoking. Engaging in healthy behavior gets you back on the road to recovery."



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