The great Hanshin-Awaji earthquake aggravates blood pressure control in treated hypertensive patients

Abstract

A major earthquake (Hanshin-Awaji earthquake) struck Kobe on January 17, 1995. We had a unique opportunity to study the effect of tremendous psychological stress on blood pressure control in 221 hypertensive patients receiving antihypertensive medication. During the 4 weeks after earthquake, on average, the mean blood pressure increased significantly for both 105 patients who were exposed (living in the area of the very severe earthquake) and 116 patients who were not exposed (living in the surrounding area) (+4.2 +/- 1.0 mm Hg, P < .001, and +/- 2.4 +/- 0.7 mm Hg, P < .005, respectively). In the exposed group, the increase in mean blood pressure peaked in the first week (+6.7 +/- 1.6 mm Hg, P < .001), declined thereafter, and returned to the baseline within 6 weeks after the disaster. The earthquake related blood pressure elevation was, however, significantly attenuated (P < .02) in patients receiving beta-blockers compared with those receiving other drugs. The results indicate that acute psychological stress associated with a sudden natural disaster causes blood pressure elevation in treated hypertensive patients, and suggest the beneficial effect of beta-blockers on such a stress-associated high blood pressure.

Disasters and the Heart: a Review of the Effects of Earthquake-Induced Stress on Cardiovascular Disease

“…In support of this mechanism, the earthquake-induced BP increase was less pronounced in patients taking α-and β-adrenergic blockers than in those taking other kinds of antihypertensive drugs (36,51).…”

Influence of the Great East Japan Earthquake and Tsunami 2011 on Occurrence of Cerebrovascular Diseases in Iwate, Japan

“…There have been several reports of elevation of blood pressure after huge earthquakes, 15,16 hurricane, 17 and nuclear power plant accident, 18 and elevation of serum cholesterol, triglycerides, 19 hematocrit, fibrinogen, and blood viscosity 20 were reported after previous disasters. Increases in blood pressure and aggravation of diabetes mellitus were reported after the Great East Japan earthquake and tsunami.…”

Cardiovascular Effects of an Earthquake

“…The blood pressure values recorded after the quake, compared with values before the quake, peaked in the first week after the seismic episode and, on average, returned to baseline after a time interval ranging from 4 to 6 weeks to 6 months. 9,10 According to Kario et al, 11 the blood pressure increase induced by the earthquake was associated with potentiation of other cardiovascular risk factors (including increases in hematocrit levels, plasma fibrinogen, plasma von Willebrand factor, and plasma D-dimer concentration) possibly involved in triggering the more frequent cardiovascular events occurring after such an incident.…”