YaAn earthquake increases blood pressure among hospitalized patients

Comparative Analysis of the Wounded in Patients and Deaths in a Hospital Following the Three Major Earthquakes in Western China

The purpose of this study was to analyze the injury characteristics of patients and therapeutic strategies for patients injured in the last three big earthquakes in China, so as to provide a reference for the improvement of emergency plans for earthquakes. The analysis was based on the data provided by the Mianyang Central Hospital (MCH) from May 12th, 2008 to September 26th, 2017. Microsoft EXCEL software was used for data input, and SPSS was used for statistical analysis. A total of 1,390 earthquake-related patients were hospitalized in MCH. Most patients were admitted to the hospital within the first 2 weeks after the earthquake. The main causes for seismic injuries involved hit/strike by objects or building collapse /burying. Extremity fractures accounted for most injuries, especially 3 days after an earthquake. But soft tissue injuries cannot be neglected. Most earthquake patients were mainly treated by means of surgery and the majority were related to orthopedics. We found that different areas, population, and religions needed a tailored approach to the rescue effort. Therefore, the earthquake magnitude scale has a significant influence on mechanisms, types and severity of the injury of patients injured in earthquakes, as well as their timely transfer, management, and prognosis. Traumatic injuries are very common and thereby various surgical procedures especially orthopedic and neurosurgery are the domain of treatment modalities. Disaster preparedness and combined surgical team effort need to be focused on to reduce both mortality and morbidity.

Anxiety Disorder Associated with the COVID-19 Pandemic Causes Deterioration of Blood Pressure Control in Primary Hypertensive Patients

Objective

The new coronavirus disease (COVID-19) has spread rapidly all over the world and caused anxiety disorders. Recent studies have also shown that the prevalence of depression and anxiety increased during the COVID-19 outbreak. We aimed to evaluate the anxiety and depression levels during the pandemic and identify the effect of pandemic-related stress on blood pressure (BP) control in primary hypertensive patients.

Method

A total of 142 patients with primary hypertension (HT) who continued to use the same antihypertensive drugs before and during the pandemic were included in the study. Twenty-four -hour Ambulatory Blood Pressure Monitoring (ABPM) and the Hospital Anxiety and Depression Scale (HADS) questionnaire were applied to patients. We retrospectively reviewed 24-h ABPM records of the same patients for the year before the pandemic.

Results

Daytime, nighttime and 24 -hour-systolic blood pressure (SBP) levels as well as daytime, nighttime, and 24- hour-diastolic blood pressure (DBP) levels , were significantly elevated during the COVID-19 outbreak compared to the pre-pandemic period (p<0.001). Higher HADS-A scores (HADS-A ≥7) were significantly associated with much greater increase in BP compared to the patients with lower HADS-A scores.

Conclusion

Psychological stress due to the COVID-19 outbreak led to worsening of the regulation of BP in controlled hypertensive patients whose antihypertensive treatments did not change.

Cardiovascular Diseases in Natural Disasters; a Systematic Review

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.

Chronological Impact of Earthquakes on Blood Pressure: A Literature Review and Retrospective Study of Hypertension in Haiti Before and After the 2010 Earthquake

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.

Self-Reported Oil Spill Exposure and Pregnancy Complications: The GROWH Study

Adverse infant outcomes often rise in the aftermath of disaster, but few studies have assessed the effects of disaster on maternal health. 1091 southern Louisiana women were interviewed about their pregnancy history, including pregnancy complications. Associations between oil spill exposures and gestational diabetes, hypertensive disorders, and nausea/vomiting were assessed for all reported pregnancies. 631 women had a pregnancy both before and after the oil spill. Generalized estimating equations (logistic regression) with adjustment for confounders were used. To assess possible unmeasured confounding, instead of considering oil spill exposure as a time-varying exposure, women were defined as oil spill-exposed or not. If oil spill-exposed women were equally prone to complications in pregnancies that occurred prior to the oil spill as after it, it was considered that any associations were likely due to selection or reporting issues. Women who reported oil spill exposure, particularly loss of use of the coast, were more likely to report gestational diabetes; however, the level of association was similar for pregnancies before and after the spill (p for interaction >0.10 and odds ratios (ORs) for pregnancies prior to the spill > than those after the spill). No associations were found between oil spill exposure and hypertensive disorders. This analysis does not suggest an increased risk of pregnancy complications associated with exposure to the oil spill; however, future studies should assess exposure and outcomes prospectively and clinically instead of relying on self-report.