April 3, 2011 (New Orleans, Louisiana) — Residents of New Orleans have a persistent threefold increased risk of heart attack four years after Hurricane Katrina, despite the fact that there has been no change in traditional risk factors, such as blood pressure, obesity, and diabetes, a doctor from the city told the audience today here at the American College of Cardiology (ACC) 2011 Scientific Sessions.
The findings build on an initial study that also indicated a threefold increased risk of MI two years after the disaster, compared with statistics from before the storm . The new results indicate that the impact of Katrina was more far-reaching than expected and have implications for the survivors of other catastrophes around the world, including the recent earthquake, tsunami, and nuclear accident in Japan, Dr Anand Irimpen (Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA) told a press conference here today.
Irimpen and colleagues also found that a number of novel factors have emerged that appear to be contributing to MI postcatastrophe that had not affected the findings two years earlier. Psychiatric disorders (such as depression, schizophrenia, and anxiety disorder), a history of coronary artery disease, and marital status, for example, seem to have played a significant role, he said, indicating that "whatever the country or people involved, it is likely that, healthwise, there will exist a negative impact."
Our findings four years post-Katrina are quite profound. We should pay closer attention to people affected by major disasters in the US and beyond our shores.
"The data were surprising for us; we thought we would see a downward trend after another two years. Our findings four years post-Katrina are quite profound. We should pay closer attention to people affected by major disasters in the US and beyond our shores, because the long-term detrimental effects on the health of a community are far-reaching and may even be passed on to the next generation," he noted.
To heartwire , he stressed that "it's important to let people know that they should give health a priority. Concentrate on diet and exercise, be compliant with your medications, and make an appointment with your doctor." The moderator of the press conference, Dr William Zoghbi (Methodist Hospital, Houston, TX), agreed, noting that there are "a lot of implications here for what happens after a disaster."
Victims Too Stressed to Pay Attention to Ideal Health Practices
Irimpen and colleagues reported their experiences in a poster . In their single-center, retrospective study, they compared two groups--those admitted to Tulane Medical Center for MI in the two years prior to Hurricane Katrina and those admitted in the four years after the hospital reopened, five months after the disaster.
In the post-Katrina group, there were 629 confirmed acute-MI admissions, out of a total census of 29 228 patients (2.2%); in the pre-Katrina group, there were 150 acute MI admissions out of a total of 21 229 patients (0.7%) (p<0.0001).
The researchers found that the patients they saw after the disaster were much more likely to lack insurance and not be compliant with their medications, among other things, he said.
Comparison of Patients Experiencing MI Before and After Hurricane Katrina
|Status or factor||Post-Katrina MI, n=629 (%)||Pre-Katrina MI, n=150 (%)||p|
|Lack of medical insurance||12||6||<0.0001|
|Less compliance with treatment||25||7||<0.0001|
|Reporting substance abuse||16||7||<0.0001|
|Single or divorced||30||26||<0.05|
|History of CAD||46||31||<0.001|
"Many of the patients we see are not yet back to their pre-Katrina residences--they are living in places that they cannot call their own, living with family members or in temporary homes; they have not yet gained employment, and are too stressed to pay attention to ideal health practices," Irimpen said.
"Chronic stress, and how people deal with it--overdoing those things that are detrimental to health (such as smoking, alcohol, substance abuse, overeating, and not yet resuming exercise habits)--appears to play an ongoing role."
Irimpen said initiatives such as trailer pharmacies and trailer gyms should be set up in the wake of disasters such as Katrina to help people remain compliant with medication and resume exercise plans.
No disclosures are listed for Irimpen.
Heartwire from Medscape © 2011 Medscape, LLC
Cite this: Tripling of Heart Attack Risk Persists 4 Years After Katrina - Medscape - Apr 03, 2011.