Stress and Cardiovascular Disease: Lessons From Katrina

Edward D. Frohlich, M.D., F.A.C.C.; Robert S. Schwartz, M.D., F.A.C.C.



In This Article


Add to death and taxes the certainty of disasters. Each day disasters occur, affecting millions of people each year. Whether natural or human-made, the extreme and overwhelming forces of disaster can have far-reaching effects on individuals, local communities, and national stability. Though disastrous events may last from seconds to days, effects can continue from months to years. In the case of the 1972 Buffalo Creek dam collapse in West Virginia, for example, when survivors were examined 14 years later using standard diagnostic criteria, 25% had post-traumatic stress disorder (PTSD).[1]

According to estimates from the National Center for Post-Traumatic Stress Disorder, approximately 25-30% of individuals exposed to unusually traumatic events such as disasters, combat, violence, and accidents develop chronic PTSD or other psychiatric disorders.[2] The center adds that the literature examining the role of traumatic exposure is definitive: regardless of the traumatic stressor, "dose-response" is a strong predictor of who will likely be most affected (Slide 1). In general, according to the National Center for PTSD, the greater the perceived life threat, the greater the personal injury, and the greater the sensory exposure to distressing sights, sounds, and odors, the more likely PTSD will manifest.

Factors Associated with the Highest Risk for Extreme Peritraumatic Stress.

Victims are not the only ones at risk. Helpers, including medical, morgue, and security personnel and rescue, fire and safety workers, also may experience either direct or indirect traumatization. Family members of victims, too, are at risk for what has been referred to as vicarious traumatization-relationships with traumatized individuals can create much distress for others.


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