The Great East Japan Earthquake Disaster and Cardiovascular Diseases

Study Questions:

What is the longer-term occurrence of all types of cardiovascular diseases (CVDs) after great earthquakes?


The investigators retrospectively examined the impact of the Earthquake on the occurrences of CVDs and pneumonia by comparing the ambulance records made by doctors in the Miyagi Prefecture, the center of the disaster area, during the periods of 2008–2011 (n = 124,152). To assess the differences in the occurrences of CVDs and pneumonia before and after the Earthquake between 2011 and the previous 3 years, the authors applied the Poisson regression model to the daily occurrences in 2008–2011 with the “dummy” variables, which indicate the individual weeks in 2011.


The weekly occurrences of CVDs, including heart failure (HF), acute coronary syndrome (ACS), stroke, cardiopulmonary arrest (CPA), and pneumonia were all significantly increased after the Earthquake compared with the previous 3 years. The occurrences of ACS and CPA showed the rapid increase followed by a sharp decline, whereas those of HF and pneumonia showed a prolonged increase for more than 6 weeks, and those of stroke and CPA showed a second peak after the largest aftershock (April 7, 2011). Furthermore, the occurrence of CPA was increased in the first 24 hours after the Earthquake, followed by other diseases later on. These increases were independent of age, sex, or residence area (seacoast vs. inland).


The authors concluded that the occurrences of all types of CVDs and pneumonia were increased in somewhat different time courses after the Earthquake.


The study reports that the occurrences of CVDs and pneumonia were all significantly increased after the Great East Japan Earthquake in 2011 when compared with the previous 3 years (2008–2010), and the occurrences of HF and pneumonia then gradually decreased, whereas the occurrences of ACS, stroke, and CPA rapidly decreased when compared with those of HF and pneumonia. Finally, the occurrences of CVDs were increased independent of age, sex, or residence area, but the increase in the occurrence of pneumonia was higher in the seacoast (tsunami) area than in the inland area. The longer-term impact on CVD is likely a consequence of persistent stress as well as the humanitarian catastrophe, i.e., breakdown of food, water, and other basic supplies. Additional studies are required to further elucidate the mechanisms of disaster-related CVDs and how to prevent them.

Clinical Topics: Acute Coronary Syndromes, Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Japan, Stroke, Acute Coronary Syndrome, Pneumonia, Tsunamis, Earthquakes, Disasters, Heart Failure, Cardiovascular Diseases, Risk Factors

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