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Influence of stress induced by the first announced state of emergency due to coronavirus disease 2019 on outpatient blood pressure management in Japan. Hypertens Res 2021; 45:675-685. [PMID: 34952950 PMCID: PMC8705072 DOI: 10.1038/s41440-021-00832-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/06/2021] [Accepted: 11/05/2021] [Indexed: 01/10/2023]
Abstract
To prevent further spread of coronavirus disease 2019 (COVID-19), the Japanese government announced a state of emergency, resulting in major stress for the population. The aim of this study was to investigate a possible association between changes in daily stress and blood pressure (BP) in Japanese patients. We retrospectively investigated 748 patients with chronic disease who were treated by the Sagamihara Physicians Association to determine changes in stress during the COVID-19 state of emergency from 7 April to 31 May 2020. During the state of emergency, office BP significantly increased from 136.5 ± 17.5/78.2 ± 12.0 to 138.6 ± 18.6/79.0 ± 12.2 (p < 0.001 and p = 0.03, respectively). In contrast, home BP significantly decreased from 128.2 ± 10.3/75.8 ± 8.8 to 126.9 ± 10.2/75.2 ± 9.0 (p < 0.001 and p = 0.01, respectively), and the ratio of white coat hypertension was significantly increased (p < 0.001). Fifty-eight percent of patients worried about adverse effects of hypertension as a condition contributing to the severity and poor prognosis of COVID-19; decreased amounts of exercise and worsened diet compositions were observed in 39% and 17% of patients, respectively. In conclusion, a significant increase in office BP with the white coat phenomenon was observed during the state of emergency, as well as an increase in related stress. To prevent cardiovascular events, general practitioners should pay more attention to BP management during stressful global events, including the COVID-19 pandemic.
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Babaie J, Pashaei Asl Y, Naghipour B, Faridaalaee G. Cardiovascular Diseases in Natural Disasters; a Systematic Review. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021; 9:e36. [PMID: 34027431 PMCID: PMC8126350 DOI: 10.22037/aaem.v9i1.1208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: As a result of destruction and lack of access to vital infrastructures and mental stress, disasters intensify cardiovascular diseases (CVDs) and hence management of CVDs becomes more challenging. The aim of this study is investigating incidence and prevalence of CVDs, morbidity and mortality of CVDs, treatment and management of CVDs at the time of natural disasters. Methods: In the present systematic review, the articles published in English language until 28. 11. 2020, which studied CVDs in natural disasters were included. The inclusion criteria were CVDs such as myocardial infarction (MI), acute coronary syndrome (ACS), hypertension (HTN), pulmonary edema, and heart failure (HF) in natural disasters such as earthquake, flood, storm, hurricane, cyclone, typhoon, and tornado. Result: The search led to accessing 4426 non-duplicate records. Finally, the data of 104 articles were included in quality appraisal. We managed to find 4, 21 and 79 full text articles, which considered cardiovascular diseases at the time of flood, storm, and earthquake, respectively. Conclusion: Prevalence of CVD increases after disasters. Lack of access to medication or lack of medication adjustment, losing home blood pressure monitor as a result of destruction and physical and mental stress after disasters are of the most significant challenges of controlling and managing CVDs. By means of quick establishment of health clinics, quick access to appropriate diagnosis and treatment, providing and access to medication, self-management, and self-care incentives along with appropriate medication and non-medication measures to control stress, we can better manage and control cardiovascular diseases, particularly hypertension.
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Affiliation(s)
- Javad Babaie
- Department of Health Policy& Management, Tabriz University of Medical Sciences, Tabriz, Iran.,Tabriz Health Services Management Research Center,Tabriz University of Medical Sciences, Tabriz, Iran.,Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Pashaei Asl
- Department of Health Policy& Management, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Health Services Management, School of Health Management and information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Bahman Naghipour
- Department of Anaesthesiology and Intensive Care, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gholamreza Faridaalaee
- Emergency Medicine Research Team, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Emergency Medicine, Maragheh University of Medical Sciences, Maragheh, Iran.,Disaster Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
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3
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Fath AR, Aglan A, Platt J, Yaron JR, Varkoly KS, Beladi RN, Gorgas D, Jean JT, Dasni P, Eldaly AS, Juby M, Lucas AR. Chronological Impact of Earthquakes on Blood Pressure: A Literature Review and Retrospective Study of Hypertension in Haiti Before and After the 2010 Earthquake. Front Public Health 2021; 8:600157. [PMID: 33520917 PMCID: PMC7844318 DOI: 10.3389/fpubh.2020.600157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/08/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: We review prior studies on the incidence of hypertension (HTN) after earthquakes and present a retrospective analysis of HTN after the 2010 earthquake in Haiti. Methods: Prior reports on HTN incidence were reviewed and a retrospective chart review for diagnosis of HTN in 4,308 patient charts was performed over a 7 year period (five clinics). A retrospective cohort study (RCS) was then performed on 11 patients with linear follow-up. Results: The Literature review revealed a significant increase in acute and subacute HTN following earthquakes. However, the chronic effects of earthquakes varied. Our chart review uncovered no significant difference in diagnosed HTN in a Fort-Liberté clinic 128 kilometers (km) distant and 4 weeks post-event. A secondary linear RCS for 11 individuals, prior to and after the earthquake, also did not detect a significant change in HTN prevalence. Conclusion: Prior studies demonstrate acute and subacute, increases in HTN after earthquakes, but late changes have varied. Retrospective studies in the Fort-Liberté clinic, 128 km distant and 4 weeks post-event, revealed no significant change in HTN, confirming prior findings that changes in HTN after earthquakes are early and local events. Further work examining HTN after earthquakes is needed to improve early health care after natural disasters.
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Affiliation(s)
- Ayman R Fath
- Internal Medicine Department, Creighton University, Phoenix, AZ, United States
| | - Amro Aglan
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Jeri Platt
- Glen Echo Presbyterian Church, Columbus, OH, United States
| | - Jordan R Yaron
- Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, AZ, United States
| | - Kyle S Varkoly
- Kansas City University, Joplin, Kansas City, MO, United States
| | - Roxana N Beladi
- Kansas City University, Joplin, Kansas City, MO, United States
| | - Diane Gorgas
- Department of Emergency Medicine and Office of Global Health, Ohio State University's Wexner Medical Center, Columbus, OH, United States
| | - Jean Tom Jean
- Jerusalem Baptist Church, Fort-Liberté, Haiti.,Santiago Medical School, Santiago, Dominican Republic
| | | | - Abdullah S Eldaly
- Plastic and Reconstructive Surgery Department, Tanta University Hospitals, Tanta, Egypt
| | - Michael Juby
- Midwestern University Medical School, Phoenix, AZ, United States
| | - Alexandra R Lucas
- Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, AZ, United States.,Internal Medicine Department, Creighton University Arizona Health Education Alliance, Phoenix, AZ, United States
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4
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Hoshide S, Nishizawa M, Okawara Y, Harada N, Kunii O, Shimpo M, Kario K. Salt Intake and Risk of Disaster Hypertension Among Evacuees in a Shelter After the Great East Japan Earthquake. Hypertension 2019; 74:564-571. [PMID: 31280649 DOI: 10.1161/hypertensionaha.119.12943] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated the association between salt intake and risk of disaster hypertension. We analyzed the data of surveys evaluating the health condition of evacuees in shelters after the Great East Japan Earthquake on April 30 and May 5, 2011. Among 272 subjects who completed the basic health condition questionnaire and underwent a medical examination, 158 (58%) had disaster hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg). Average estimated sodium intake assessed by spot urine was significantly associated with disaster hypertension (odds ratio per 1 g/d, 1.16; 95% CI, 1.05-1.30). When we defined the high risk factors for salt-sensitive hypertension as older age (≥65 years), obesity (body mass index, ≥25 kg/m2), chronic kidney disease, and diabetes mellitus, estimated sodium intake was found to be a risk factor for disaster hypertension in the total group (odds ratio per 1 g/d, 1.27; 95% CI, 1.12-1.43) and even in the group without prevalent hypertension before disaster (n=146; odds ratio per 1 g/d, 1.46; 95% CI, 1.19-1.79). There was an interaction between estimated sodium intake and disaster hypertension according to the presence or absence of high risk of salt-sensitive hypertension in the group without prevalent hypertension (P=0.03). Disaster hypertension conferred a risk of microalbuminuria (odds ratio, 3.00; 95% CI, 1.71-5.26; P<0.001). We conclude that increased estimated sodium intake was associated with disaster hypertension in evacuees after disaster. This association was noted in the population with high risk of salt-sensitive hypertension and without prevalent hypertension before natural disaster. Additionally, disaster hypertension was associated with subclinical organ damage.
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Affiliation(s)
- Satoshi Hoshide
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (S.H., M.N., Y.O., N.H., M.S., K.K.)
| | - Masafumi Nishizawa
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (S.H., M.N., Y.O., N.H., M.S., K.K.).,Department of Medicine, Minamisanriku Hospital, Miyagi, Japan (M.N.)
| | - Yukie Okawara
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (S.H., M.N., Y.O., N.H., M.S., K.K.)
| | - Noriko Harada
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (S.H., M.N., Y.O., N.H., M.S., K.K.)
| | - Osamu Kunii
- Investment and Impact Division, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Le Grand-Saconnex, Switzerland (O.K.)
| | - Masahisa Shimpo
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (S.H., M.N., Y.O., N.H., M.S., K.K.)
| | - Kazuomi Kario
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (S.H., M.N., Y.O., N.H., M.S., K.K.)
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Satoh J, Yokono K, Ando R, Asakura T, Hanzawa K, Ishigaki Y, Kadowaki T, Kasuga M, Katagiri H, Kato Y, Kurosawa K, Miura M, Nakamura J, Nishitsuka K, Ogawa S, Okamoto T, Sakuma S, Sakurai S, Satoh H, Shimauchi H, Shimokawa H, Shoji W, Sugiyama T, Suwabe A, Tachi M, Takahashi K, Takahashi S, Terayama Y, Tomita H, Tsuchiya Y, Waki H, Watanabe T, Yahata K, Yamashita H. Diabetes Care Providers' Manual for Disaster Diabetes Care. J Diabetes Investig 2019; 10:1118-1142. [PMID: 31197978 PMCID: PMC6626940 DOI: 10.1111/jdi.13053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 04/01/2019] [Indexed: 11/26/2022] Open
Abstract
To ensure that experiences and lessons learned from the unprecedented 2011 Great East Japan Earthquake are used to improve future disaster planning, the Japan Diabetes Society (JDS) launched the "Research and Survey Committee for Establishing Disaster Diabetes Care Systems Based on Relevant Findings from the Great East Japan Earthquake" under the supervision of the Chairman of the JDS. The Committee conducted a questionnaire survey among patients with diabetes, physicians, disaster medical assistance teams (DMATs), nurses, pharmacists, and nutritionists in disaster areas about the events they saw happening, the situations they found difficult to handle, and the needs that they felt required to be met during the 2011 Great East Japan Earthquake. A total of 3,481 completed questionnaires were received. Based on these and other experiences and lessons reported following the 2011 Great East Japan Earthquake and the 2004 Niigata-Chuetsu Earthquakes, the current "Manual for Disaster Diabetes Care" has been developed by the members of the Committee and other invited authors from relevant specialties. To our knowledge, the current Manual is the world's first to focus on emergency diabetes care, with this digest English version translated from the Japanese original. It is sincerely hoped that patients with diabetes and healthcare providers around the world will find this manual helpful in promoting disaster preparedness and implementing disaster relief.
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Affiliation(s)
- Jo Satoh
- Tohoku Medical and Pharmaceutical University Wakabayashi HospitalSendai
| | | | - Rie Ando
- Kanagawa University of Human ServicesYokosuka
| | - Toshinari Asakura
- Faculty of Pharmaceutical SciencesNiigata University of Pharmacy and Applied Life SciencesNiigata
| | - Kazuhiko Hanzawa
- Advanced Treatment and Prevention for Vascular Disease and EmbolismNiigata University Graduate School of Medicine and Dental SciencesNiigata
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and EndocrinologyDepartment of Internal MedicineIwate Medical UniversityMorioka
| | - Takashi Kadowaki
- Department of Prevention of Diabetes and Lifestyle‐Related DiseasesGraduate School of MedicineThe University of TokyoTokyo
- Department of Metabolism and NutritionMizonokuchi HospitalFaculty of MedicineTeikyo UniversityTokyo
| | - Masato Kasuga
- The Institute for Adult DiseasesAsahi Life FoundationTokyo
| | - Hideki Katagiri
- Department of Metabolism and DiabetesTohoku University Graduate School of MedicineSendai
| | | | | | - Masanobu Miura
- Department of Cardiovascular MedicineGraduate School of MedicineTohoku UniversitySendai
| | - Jiro Nakamura
- Division of DiabetesDepartment of Internal MedicineSchool of MedicineAichi Medical UniversityNagakute
| | - Koichi Nishitsuka
- Department of OphthalmologyFaculty of MedicineYamagata UniversityYamagata
| | - Susumu Ogawa
- Division of Nephrology, Endocrinology and Vascular MedicineTohoku University Hospital
| | | | | | - Shigeru Sakurai
- Division of Infection ControlDepartment of Medical SafetyIwate Medical University HospitalMorioka
| | - Hiroaki Satoh
- Department of Metabolism and EndocrinologyJuntendo UniversityTokyo
| | | | - Hiroaki Shimokawa
- Department of Cardiovascular MedicineGraduate School of MedicineTohoku UniversitySendai
| | - Wataru Shoji
- Department of Preventive PsychiatryGraduate School of MedicineTohoku UniversitySendai
| | - Takashi Sugiyama
- Department of Obstetrics and GynecologyEhime University Graduate School of MedicineToon
| | - Akira Suwabe
- Department of Laboratory MedicineIwate Medical University School of MedicineMorioka
| | | | | | | | - Yasuo Terayama
- Division of Neurology and GerontologyDepartment of Internal MedicineSchool of MedicineIwate Medical University Morioka
| | | | | | - Hironori Waki
- Department of Diabetes and Metabolic DiseasesGraduate School of MedicineThe University of TokyoTokyo
| | - Tsuyoshi Watanabe
- Japan Organization of Occupational Health and SafetyFukushima Rosai HospitalIwaki
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Abstract
To ensure that experiences and lessons learned from the unprecedented 2011 Great East Japan Earthquake are used to improve future disaster planning, the Japan Diabetes Society (JDS) launched the "Research and Survey Committee for Establishing Disaster Diabetes Care Systems Based on Relevant Findings from the Great East Japan Earthquake" under the supervision of the Chairman of the JDS. The Committee conducted a questionnaire survey among patients with diabetes, physicians, disaster medical assistance teams (DMATs), nurses, pharmacists, and nutritionists in disaster areas about the events they saw happening, the situations they found difficult to handle, and the needs that they felt required to be met during the 2011 Great East Japan Earthquake. A total of 3,481 completed questionnaires were received. Based on these and other experiences and lessons reported following the 2011 Great East Japan Earthquake and the 2004 Niigata-Chuetsu Earthquakes, the current "Manual for Disaster Diabetes Care" has been developed by the members of the Committee and other invited authors from relevant specialties. To our knowledge, the current Manual is the world's first to focus on emergency diabetes care, with this digest English version translated from the Japanese original. It is sincerely hoped that patients with diabetes and healthcare providers around the world will find this manual helpful in promoting disaster preparedness and implementing disaster relief.
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7
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Tsukinoki R, Murakami Y, Kawado M, Hashimoto S. Comparison of standardised mortality ratios for renal failure before and after the 2011 Great East Japan Earthquake and Tsunami: an analysis of national vital statistics. BMJ Open 2018; 8:e023435. [PMID: 30593549 PMCID: PMC6318511 DOI: 10.1136/bmjopen-2018-023435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE The impact of the 2011 Great East Japan Earthquake on renal failure (RF) risk remains unclear. We examined the 1-year impact of this disaster on RF mortality. SETTING This ecological study focused on the year before and after the earthquake. The data sources were national vital statistics (2010-2012), the national census (2010) and the Basic Resident Registration (2010-2012). PARTICIPANTS Our study included all residents in Iwate, Miyagi and Fukushima, 1 year before and after the earthquake. PRIMARY AND SECONDARY OUTCOME MEASURES We calculated standardised mortality ratios (SMRs) for RF, chronic RF and acute RF. Postearthquake weekly SMRs were calculated using the number of RF deaths for the corresponding weeks in 2010 as a reference. The SMRs for RF were compared between the coastal and inland municipalities using kernel-weighted polynomial smoothing. RESULTS There were 1290 RF deaths in the three prefectures during the year after the earthquake (chronic RF: 804 and acute RF: 236). The SMR for RF increased significantly in the first week after the earthquake in coastal areas (3.11; 95% CI: 1.84 to 4.37), but did not increase in inland areas (0.93; 95% CI: 0.47 to 1.38). A similar trend was observed for chronic RF (coastal: 4.0; 95% CI: 2.0 to 6.0; inland: 1.1; 95% CI: 0.4 to 1.7). SMRs for RF and chronic RF decreased over time and reached 1.0 approximately 20 weeks after the disaster. Changes in SMRs for acute RF were not apparent due to the low number of deaths. CONCLUSIONS Mortality due to RF and chronic RF, but not acute RF, increased in coastal areas after the earthquake. Chronic RF may have been exacerbated by disaster-induced sympathetic activation and poor management of renal dysfunction. Increased hypertension and damage to essential infrastructure and medical equipment may also have increased mortality in people with kidney disease.
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Affiliation(s)
- Rumi Tsukinoki
- Department of Public Health Nursing, Japanese Red Cross College of Nursing, Tokyo, Japan
| | | | - Miyuki Kawado
- Department of Hygiene, Fujita Health University School of Medicine, Aichi, Japan
| | - Shuji Hashimoto
- Department of Hygiene, Fujita Health University School of Medicine, Aichi, Japan
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Suneja A, Gakh M, Rutkow L. Burden and Management of Noncommunicable Diseases After Earthquakes and Tsunamis. Health Secur 2018; 16:30-47. [PMID: 29355393 DOI: 10.1089/hs.2017.0059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This integrative review examines extant literature assessing the burden and management of noncommunicable diseases 6 months or more after earthquakes and tsunamis. We conducted an integrative review to identify and characterize the strength of published studies about noncommunicable disease-specific outcomes and interventions at least 6 months after an earthquake and/or tsunami. We included disasters that occurred from 2004 to 2016. We focused primarily on the World Health Organization noncommunicable disease designations to define chronic disease, but we also included chronic renal disease, risk factors for noncommunicable diseases, and other chronic diseases or symptoms. After removing duplicates, our search yielded 6,188 articles. Twenty-five articles met our inclusion criteria, some discussing multiple noncommunicable diseases. Results demonstrate that existing medical conditions may worsen and subsequently improve, new diseases may develop, and risk factors, such as weight and cholesterol levels, may increase for several years after an earthquake and/or tsunami. We make 3 recommendations for practitioners and researchers: (1) plan for noncommunicable disease management further into the recovery period of disaster; (2) increase research on the burden of noncommunicable diseases, the treatment modalities employed, resulting population-level outcomes in the postdisaster setting, and existing models to improve stakeholder coordination and action regarding noncommunicable diseases after disasters; and (3) coordinate with preexisting provision networks, especially primary care.
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Noncommunicable Diseases After the Great East Japan Earthquake: Systematic Review, 2011-2016. Disaster Med Public Health Prep 2017; 12:396-407. [PMID: 29032775 DOI: 10.1017/dmp.2017.63] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Noncommunicable diseases (NCDs), including mental disorders, have become major threats to human health worldwide. People with NCDs are particularly vulnerable to disasters. We systematically reviewed reports describing studies of NCDs at the time of the Great East Japan Earthquake (GEJE) to clarify the circumstances of people with NCDs and to build strong measures to support them. METHODS Relevant articles published from March 2011 through December 2016 were collected by searching the PubMed database (National Library of Medicine). We specifically examined reports describing NCDs and including the key words "East Japan Earthquake." NCDs included every disease type aside from injury and infectious disease. RESULTS We collected 160 relevant articles, 41 of which described NCDs that existed in residents before the GEJE. Articles describing respiratory diseases and mental illnesses were found most frequently. Interruption of regular treatment was the most frequent problem, followed by lack of surveillance capacity. We found 101 reports describing NCDs that had developed after the GEJE, of which 60% were related to mental health issues. CONCLUSIONS NCDs pose major health issues after large-scale disasters. Establishment of strong countermeasures against interruption of treatment and surveillance systems to ascertain medical needs for NCDs are necessary to prepare for future disasters. (Disaster Med Public Health Preparedness. 2018; 12: 396-407).
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Hashimoto S, Nagai M, Fukuma S, Ohira T, Hosoya M, Yasumura S, Satoh H, Suzuki H, Sakai A, Ohtsuru A, Kawasaki Y, Takahashi A, Ozasa K, Kobashi G, Kamiya K, Yamashita S, Fukuhara SI, Ohto H, Abe M. Influence of Post-disaster Evacuation on Incidence of Metabolic Syndrome. J Atheroscler Thromb 2017; 24:327-337. [PMID: 27629253 PMCID: PMC5383548 DOI: 10.5551/jat.35824] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 07/03/2016] [Indexed: 01/29/2023] Open
Abstract
AIM After the Great East Japan Earthquake, over 160,000 residents near the Fukushima Daiichi Nuclear Power Plant were forced to evacuate due to a nuclear accident. Health problems in these evacuees have since become major issues. We examined the association between evacuation and incidence of metabolic syndrome (METS) among residents in Fukushima. METHODS We conducted a cohort study among residents aged 40-74 years without METS at the time of the disaster in Fukushima. Among 20,269 residents who met the inclusion criteria before the disaster, 8,547 residents (3,697 men and 4,850 women; follow-up proportion: 42.2%) remained available for follow-up examinations after the disaster by the end of March 2013. The main outcome was incidence of METS, defined by guidelines from the Japanese committee, using data from the Comprehensive Health Check before and after the disaster. We divided participants by evacuation status and compared outcomes between groups. Using a logistic regression model, we estimated the odds ratio for incidence of METS, adjusting for potential confounders, age, gender, waist circumference, exercise habit, and alcohol consumption. RESULTS Incidence of METS was higher in evacuees (men 19.2%, women 6.6%) than in non-evacuees (men 11.0%, women 4.6%). Evacuees had higher body mass index, waist circumference, triglycerides, and fasting plasma glucose after the disaster than non-evacuees. We found a significant association between evacuation and incidence of METS (adjusted odds ratio 1.72, 95% confidence interval; 1.46-2.02). CONCLUSION This is the first study to demonstrate that evacuation after a disaster is associated with increased incidence of METS.
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Affiliation(s)
- Shigeatsu Hashimoto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Masato Nagai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Shingo Fukuma
- Department of Healthcare Epidemiology, Kyoto University School of Public Health, Kyoto, Japan
- Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, Fukushima Medical University, Fukushima, Japan
| | - Hiroaki Satoh
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Nephrology, Hypertension, Diabetology, and Endocrinology, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Radiation Life Sciences, Fukushima Medical University, Fukushima, Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Gastroenterology and Rheumatology, Fukushima Medical University, Fukushima, Japan
| | - Kotaro Ozasa
- Department of Epidemiology, The Radiation Effects Research Foundation, Hiroshima, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Shunichi Yamashita
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Shun-ichi Fukuhara
- Department of Healthcare Epidemiology, Kyoto University School of Public Health, Kyoto, Japan
- Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Masafumi Abe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Fukushima Health Management Survey Group
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
- Department of Healthcare Epidemiology, Kyoto University School of Public Health, Kyoto, Japan
- Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, Fukushima Medical University, Fukushima, Japan
- Department of Nephrology, Hypertension, Diabetology, and Endocrinology, Fukushima Medical University, Fukushima, Japan
- Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan
- Department of Radiation Life Sciences, Fukushima Medical University, Fukushima, Japan
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan
- Department of Gastroenterology and Rheumatology, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, The Radiation Effects Research Foundation, Hiroshima, Japan
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
- Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
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Shiraishi Y, Kujiraoka T, Hakuno D, Masaki N, Tokuno S, Adachi T. Elevation of Derivatives of Reactive Oxygen Metabolites Elevated in Young "Disaster Responders" in Hypertension due to Great East Japan Earthquake. Int Heart J 2016; 57:61-6. [PMID: 26742880 DOI: 10.1536/ihj.15-303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There have been very few studies on serum biomarkers associated with hypertension in disaster situations. We assessed biomarkers associated with disaster-related hypertension (DRH) due to the Great East Japan Earthquake of March 2011.We collected blood samples from members of the Japan Self Defense Forces (JSDF) (n = 77) after completing disaster relief operations. We divided them into two groups based on systolic blood pressure. We defined DRH as either systolic blood pressure greater than 140 mmHg or diastolic blood pressure greater than 90 mmHg at the time of completing missions.In subjects with DRH, the mean blood pressure was 143.5 ± 5.0/99.5 ± 2.4 mmHg. Height and body weight measurements were slightly greater in the DRH group but the differences were not significant, and age was significantly higher in the DRH group. There were no differences in serum biochemical tests including metabolic markers, sulfur-containing amino acids, and cytokines. Among nitric oxide-related amino acids, asymmetric dimethylarginine (ADMA) was lower in the DRH group than in the normotension group (0.40 ± 0.02 versus 0.31 ± 0.02 μmol/L P = 0.04). The serum oxidative stress metabolite levels (d-ROMs; indicators of active oxygen metabolite products) were significantly higher in the DRH group (273.6 ± 6.08 versus 313.5 ± 13.7 U.CARR P = 0.016). Using multivariable regression analysis, d-ROMs levels were particularly predictive for DRH.Oxidative stress is associated with DRH in responders to the disaster of the Great East Japan Earthquake.
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Affiliation(s)
- Yasunaga Shiraishi
- Department of Internal Medicine, Division of Cardiovascular Medicine, National Defense Medical College
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12
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Tomio J, Sato H. Emergency and disaster preparedness for chronically ill patients: a review of recommendations. Open Access Emerg Med 2014; 6:69-79. [PMID: 27147882 PMCID: PMC4753992 DOI: 10.2147/oaem.s48532] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Recent disasters, especially those in developed countries, have highlighted the importance of disaster preparedness measures for chronic diseases. A number of surviving patients experienced the exacerbation of a chronic illness, such as hypertension, diabetes, cancer, and chronic respiratory diseases, due to disaster-related stress, interruption of care, or both; for some patients, these exacerbations resulted in death. Here, we review reports from recent disasters in developed countries and summarize the recommendations for disaster preparedness of chronically ill patients. A considerable number of recommendations based on the lessons learned from recent disasters have been developed, and they provide practical and essential steps to prevent treatment interruption during and after a disaster. To improve preparedness efforts, we suggest that health care providers should be aware of the following three suggestions: 1) recommendations should be evidence-based; 2) recommendations should contain consistent messages; and 3) recommendations should be feasible.
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Affiliation(s)
- Jun Tomio
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hajime Sato
- Department of Health Policy and Technology Assessment, National Institute of Public Health, Wako, Japan
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Watanabe T. [The 41st Scientific Meeting: perspectives of internal medicine; lessons from the disaster of the Great East Japan earthquake: 3. Medical disease learned from the Great East Japan earthquake--feature, treatment and prevention--; 4) Status of medical care on dialysis patients and patients with chronic life-style related diseases after Great East-Japan earthquake: lesson from our experiences in Fukushima and future perspectives]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2014; 103:561-571. [PMID: 24796117 DOI: 10.2169/naika.103.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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14
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Disaster nephrology: crush injury and beyond. Kidney Int 2013; 85:1049-57. [PMID: 24107850 DOI: 10.1038/ki.2013.392] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 07/20/2013] [Accepted: 07/25/2013] [Indexed: 01/09/2023]
Abstract
Disasters result in a substantial number of renal challenges, either by the creation of crush injury in victims trapped in collapsed buildings or by the destruction of existing dialysis facilities, leaving chronic dialysis patients without access to their dialysis units, medications, or medical care. Over the past two decades, lessons have been learned from the response to a number of major natural disasters that have impacted significantly on crush-related acute kidney injury and chronic dialysis patients. In this paper we review the pathophysiology and treatment of the crush syndrome, as summarized in recent clinical recommendations for the management of crush syndrome. The importance of early fluid resuscitation in preventing acute kidney injury is stressed, logistic difficulties in disaster conditions are described, and the need for an implementation of a renal disaster relief preparedness program is underlined. The role of the Renal Disaster Relief Task Force in providing emergency disaster relief and the logistical support required is outlined. In addition, the importance of detailed education of chronic dialysis patients and renal unit staff in the advance planning for such disasters and the impact of displacement by disasters of chronic dialysis patients are discussed.
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15
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Blood pressure elevation in hemodialysis patients after the Great East Japan Earthquake. Hypertens Res 2013; 37:139-44. [DOI: 10.1038/hr.2013.116] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 05/21/2013] [Accepted: 07/06/2013] [Indexed: 11/08/2022]
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16
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Konno S, Hozawa A, Munakata M. Blood pressure among public employees after the Great East Japan Earthquake: the Watari study. Am J Hypertens 2013; 26:1059-63. [PMID: 23694920 DOI: 10.1093/ajh/hpt065] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Increases in blood pressure were reported in overworked public workers following the Mid-Niigata earthquake. This study aimed to compare blood pressure changes between public employees and the general population after the Great East Japan Earthquake of March 2011. METHODS We analyzed 1,776 individuals from the general population and 240 public employees of the town of Watari who received medical check-ups in 2010 and from July 2011 through November 2011. Anthropometric parameters and sitting blood pressure were compared, and fasting blood samples were taken from all participants. In post-disaster measurements, the degrees of insomnia, depression, fatigue, and life disruption due to the disaster were assessed using a questionnaire. Information on the working hours of public employees was obtained from authorized sources. RESULTS After age-sex adjustments, the public employees showed greater increases in systolic (11.3 vs. -1.9mm Hg, P < 0.001) and diastolic (7.8 vs. 1.1mm Hg, P < 0.001) blood pressure than the general population when compared with measurements taken during the previous year. In contrast, the degrees of fatigue, depression, and life disruption were equivalent in the 2 groups. The average monthly overtime hours worked by public employees in March 2011 was 10-fold higher compared with the previous March. CONCLUSION Public employees showed greater and more prolonged increases in blood pressure than the general population after the Great East Japan earthquake. Thus blood pressure should be monitored after a great earthquake among public employees, and treatment should be considered if necessary.
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Affiliation(s)
- Satoshi Konno
- Preventive Medical Center and Division of Hypertension, Tohoku Rosai Hospital, Sendai, Japan
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Tanaka K, Nakayama M, Kanno M, Kimura H, Watanabe K, Tani Y, Hayashi Y, Asahi K, Suzuki K, Watanabe T. Home blood pressure control after the great East Japan earthquake in patients on chronic hemodialysis. Ther Apher Dial 2013; 18:149-54. [PMID: 24720405 DOI: 10.1111/1744-9987.12072] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
At 14:46 on 11 March 2011, northeastern Japan was struck by a major earthquake measuring 9.0 on the Richter scale (the Great East Japan Earthquake). Several reports have suggested a transient blood pressure (BP) increase after a major earthquake, but its impact on BP in chronic dialysis patients has not been reported. In a retrospective review of 25 hemodialysis patients who were residents of Koriyama City, changes in the morning home BP after the earthquake were investigated. Home systolic and diastolic BPs were significantly elevated 1 week after the earthquake (158 ± 16 mm Hg vs. 151 ± 13 mm Hg, P < 0.01, for systolic; 81 ± 13 mm Hg vs. 78 ± 11 mm Hg, P = 0.01, for diastolic). Mean home BP 1 week after the earthquake was unchanged from baseline in patients treated with sympatholytics and/or renin-angiotensin system (RAS) inhibitors. BP values returned to baseline by 4 weeks after the earthquake, but percent changes in mean BP were significantly greater even 2 weeks, 4 weeks, and 6 weeks after the earthquake in patients not treated with RAS inhibitors than in those treated with RAS inhibitors (2 weeks 7.0% ± 4.5% vs. 0.2% ± 5.0%, P < 0.01; 4 weeks 4.4% ± 5.9% vs. -1.8% ± 5.3%, P = 0.02; 6 weeks 4.6% ± 4.9% vs. -1.9% ± 3.9%, P < 0.01). On multiple regression analysis, RAS inhibitor use had an independent relationship with percentage increases in mean BP during the 6 weeks after the earthquake. Home BP was significantly increased after a major earthquake in patients on chronic hemodialysis. Prolonged deterioration of BP control after the earthquake was associated with non-use of RAS inhibitors.
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Affiliation(s)
- Kenichi Tanaka
- Departments of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan; Chronic Kidney Disease Initiatives, Fukushima Medical University, Fukushima, Japan
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18
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Blood pressure in hemodialysis patients after Great East Japan earthquake in Fukushima. J Hypertens 2013; 31:1724-6. [DOI: 10.1097/hjh.0b013e328362dd5c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tanaka K, Nakayama M, Kanno M, Kimura H, Watanabe K, Hayashi Y, Asahi K, Watanabe T. Aftercare for the prevention of a secondary health disaster in survivors of major earthquakes. Hypertens Res 2013; 36:759-61. [PMID: 23842621 DOI: 10.1038/hr.2013.75] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Kenichi Tanaka
- Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan.
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Yamauchi H, Yoshihisa A, Iwaya S, Owada T, Sato T, Suzuki S, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh SI, Takeishi Y. Clinical features of patients with decompensated heart failure after the Great East Japan Earthquake. Am J Cardiol 2013; 112:94-9. [PMID: 23561586 DOI: 10.1016/j.amjcard.2013.02.057] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 02/26/2013] [Accepted: 02/26/2013] [Indexed: 01/17/2023]
Abstract
The occurrence of heart failure (HF) and its clinical features after a great disaster have not been rigorously examined. We retrospectively examined the effect of the Great East Japan Earthquake on the occurrence of decompensated HF. The number of patients admitted for treatment of decompensated HF and their clinical features were compared between 2 periods, March 11, 2011 to September 10, 2011 (after the earthquake) and the same period in the previous year. The number of admissions increased from 55 in 2010 to 84 in 2011. A comparison of the clinical features showed that the patients admitted after the earthquake had (1) older age (p = 0.031), (2) greater systolic blood pressure (p = 0.039), (3) a greater incidence of new-onset HF due to valvular heart disease (p = 0.040), (4) interruption of drugs (p = 0.001), (5) a greater incidence of infection (p = 0.019), (6) greater B-type natriuretic peptide (p = 0.005) and C-reactive protein (p = 0.003) levels, (7) a lower estimated glomerular filtration rate (p = 0.048) and lower albumin levels (p = 0.021), and (8) a larger diameter of the inferior vena cava (p = 0.008). In conclusion, these results suggest that the earthquake increased the incidence of HF in association with high blood pressure, interruption of drugs, inflammation, malnutrition, and fluid retention. Taking appropriate measures to control blood pressure, nutritional status, and hygiene environment might decrease the occurrence of HF in future disasters.
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Long-term blood pressure changes induced by the 2009 L'Aquila earthquake: assessment by 24 h ambulatory monitoring. Hypertens Res 2013; 36:795-8. [PMID: 23595046 DOI: 10.1038/hr.2013.37] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Revised: 01/21/2013] [Accepted: 01/23/2013] [Indexed: 02/08/2023]
Abstract
An increased rate of cardiovascular and cerebrovascular events has been described during and immediately after earthquakes. In this regard, few data are available on long-term blood pressure control in hypertensive outpatients after an earthquake. We evaluated the long-term effects of the April 2009 L'Aquila earthquake on blood pressure levels, as detected by 24 h ambulatory blood pressure monitoring. Before/after (mean±s.d. 6.9±4.5/14.2±5.1 months, respectively) the earthquake, the available 24 h ambulatory blood pressure monitoring data for the same patients were extracted from our database. Quake-related daily life discomforts were evaluated through interviews. We enrolled 47 patients (25 female, age 52±14 years), divided into three groups according to antihypertensive therapy changes after versus before the earthquake: unchanged therapy (n=24), increased therapy (n=17) and reduced therapy (n=6). Compared with before the quake, in the unchanged therapy group marked increases in 24 h (P=0.004), daytime (P=0.01) and nighttime (P=0.02) systolic blood pressure were observed after the quake. Corresponding changes in 24 h (P=0.005), daytime (P=0.01) and nighttime (P=0.009) diastolic blood pressure were observed. Daily life discomforts were reported more frequently in the unchanged therapy and increased therapy groups than the reduced therapy group (P=0.025 and P=0.018, respectively). In conclusion, this study shows that patients with unchanged therapy display marked blood pressure increments up to more than 1 year after an earthquake, as well as long-term quake-related discomfort. Our data suggest that particular attention to blood pressure levels and adequate therapy modifications should be considered after an earthquake, not only early after the event but also months later.
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