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Mar 10, 2013

Heart Attacks Triple After Hurricane Katrina

Researchers say psychosocial effects of the disaster play an important role.

Six years after Hurricane Katrina pummeled the Gulf Coast, residents of hard-hit New Orleans continue to face a three-fold increased risk of heart attack than they did before the storm, according to research presented at the American College of Cardiology’s 62nd Annual Scientific Session in San Francisco this week. This meeting brings together cardiologists and cardiovascular specialists from around the world each year to share the newest discoveries in treatment and prevention.

This trend has persisted since the storm hit in 2005, even though post-Katrina patients are more likely to be prescribed medications to help prevent heart attacks. At the same time, people who have had a heart attack after the storm were also less likely to take these therapies as directed or have health insurance. They were also more likely to smoke, overuse alcohol or other substances, and be burdened with high levels of stress and mental illness compared to people suffering heart attack before the storm.

“Overwhelmingly, the main differences in the pre- and post-Katrina populations involve psychosocial risk factors as opposed to shifts in traditional cardiovascular risk factors like hypertension, obesity and diabetes,” said Anand Irimpen, MD, the study’s senior investigator, associate professor of medicine at the Heart and Vascular Institute of Tulane University School of Medicine and chief of cardiology at the Southeast Louisiana Veterans Health Care System.

This study evaluated patients admitted with heart attacks to Tulane Medical Center in the two years before Katrina and the six years after the hospital reopened five months after Katrina. The new data—an update to earlier studies that compared the behavioral and heart health of New Orleans residents before and after the storm—point to the role chronic stress might play in triggering cardiac events.

“Large-scale catastrophes like Hurricane Katrina seem to create a very large shift in the population and the way it behaves and takes care of itself,” he said. “While there is a lot we can do with medications and medical interventions, those therapies become less effective based on the way the patient takes care of him or herself.”

That’s why it is important that patients who suffer with prolonged, high anxiety talk with their health care providers about their concerns and ways to manage stress, especially in the aftermath of a traumatic event. And the stress and devastation brought on by Katrina didn’t just make a heart attack more likely, but it also appears to have altered when they occur.

Like people, heart attacks tend to follow certain patterns, peaking most frequently during mid-morning on weekdays, especially Mondays. But the upheaval caused by Hurricane Katrina has since obliterated the usual timing of these cardiac events; heart attacks are now more likely to occur at night or on the weekends, which could inform decisions about hospital staffing after natural disasters.

Dr. Irimpen and his research team plan to collaborate with other centers to collect and compare data from other sites that have experienced major natural disasters, including those in the New York area following Hurricane Sandy.

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