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Predictors of Hypertension in Survivors of the Great East Japan Earthquake, 2011: A Cross-sectional Study

Published online by Cambridge University Press:  26 January 2016

Reiichiro Tanaka ,
Motohisa Okawa  and
Yoshihito Ujike
Reiichiro Tanaka*
Affiliation:
Department of Emergency Medicine, Institute of Neuroscience and Orthopedics, Okayama Kyokuto Hospital, Okayama, Japan
Motohisa Okawa
Affiliation:
Department of Health Science, College of Life Science, Kurashiki University of Science and the Arts, Okayama, Japan
Yoshihito Ujike
Affiliation:
Department of Emergency Medicine, Okayama University Hospital, Okayama, Japan
*
Correspondence: Reiichiro Tanaka, MD Department of Emergency Medicine Institute of Neuroscience and Orthopedics Okayama Kyokuto Hospital 567-1 Kurata, Nakaku Okayama 703-8265, Japan E-mail: Rtanaka17@aol.com
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Abstract

Introduction

Many survivors of a major disaster die shortly after the event. Hypertension (HT) is one of the most important risk factors for these disaster-related diseases. An urgent need exists to establish methods to detect disaster survivors with HT and start medication immediately, as those with no injuries or symptoms may not be examined and medical teams cannot measure all survivors’ blood pressure (BP) because they often do not have sufficient time.

Objective

The goals of this report were: (1) to evaluate the importance of taking antihypertensive drugs continuously for patients with HT during the sub-acute phase after a major earthquake, when patients cannot attend a clinic because of destruction of the local infrastructure; and (2) to establish simple and reliable predictors to detect evacuees with HT, who require clinical examination and treatment at evacuation shelters or in their homes after a major earthquake.

Methods

Medical rounds were performed at evacuation shelters in Iwate Prefecture after the Great East Japan Earthquake. Forty evacuees were enrolled in a cross-sectional study. The effect of taking antihypertensive drugs continuously was evaluated and predictors of HT in evacuees were identified using multiple logistic regression analysis.

Results

Twenty-eight evacuees were hypertensive (70%), nine of whom were asymptomatic (32%). Most evacuees who had discontinued antihypertensive medication (92%; 11/12) had very high BP, while those who had continued antihypertensive medication (80%; 8/10) were mildly hypertensive. The systolic BP of those who had discontinued antihypertensive drugs was significantly higher than that of those who had continued hypertensive drugs in the whole cohort (n=40), and also in evacuees diagnosed as having HT at evacuation shelters (n=28; P<.01 for both comparisons). A history of HT (adjusted odds ratio [aOR], 11.40; 95% confidence interval [CI], 1.03-126.08) or age >55 years (aOR, 1.10; 95% CI, 1.01-1.21) predicted HT with a sensitivity of 0.96 and specificity of 0.80.

Conclusions

The results of this study suggest that continuity of antihypertensive medication prevents serious HT at evacuation shelters in the first 10 days after a major earthquake. Onsite medical rounds focusing on simple predictors in an early stage after disasters may be an effective means of detecting and treating hypertensive disaster victims before they succumb to a fatal disease.

TanakaR, OkawaM, UjikeY. Predictors of Hypertension in Survivors of the Great East Japan Earthquake, 2011: A Cross-sectional Study. Prehosp Disaster Med. 2016;31(1):17–26.

Keywords

blood pressuredisaster hypertensiondisaster-related deathGreat East Japan Earthquakepsychological stress
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 1 , February 2016 , pp. 17 - 26
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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References

1. National Police Agency. The situation of damage. A list of information of Great East Japan Earthquake [in Japanese]. National Police Agency Web site. http://www.npa.go.jp/archive/keibi/biki/higaijokyo.pdf. Reported on October 9, 2015. Accessed on October 9, 2015.Google Scholar
2. Reconstruction Agency. Information for supporting the victims of Great East Japan Earthquake. The total of refugees in the whole country in Japan [in Japanese]. Reconstruction Agency Web site. http://www.reconstruction.go.jp/topics/main-cat2/sub-cat2-1/20141226_hinansha.pdf. Reported on December 26, 2014. Accessed on February 20, 2015.Google Scholar
3. Reconstruction Agency. Information for supporting the victims of Great East Japan Earthquake. The total of disaster-related death in the whole country in Japan [in Japanese]. Reconstruction Agency Web site. http://www.reconstruction.go.jp/topics/main-cat2/sub-cat2-6/20150630_kanrenshi.pdf. Reported on June 30, 2015. Accessed on October 9, 2015.Google Scholar
4. Hyogo Prefecture City-Planning/Prevention of Disaster. Hyogo Prefecture Web site. http://web.pref.hyogo.lg.jp/pa20/pa20_000000016.html. Accessed on February 20, 2015.Google Scholar
5. Leor, J, Poole, WK, Kloner, RA. Sudden cardiac death triggered by an earthquake. N Engl J Med.. 1996;334(4):413-419.CrossRefGoogle ScholarPubMed
6. Trichopoulos, D, Katsouyanni, K, Zavitsanos, X, Tzonou, A, Dalla-Vorgia, P. Psychological stress and fatal heart attack: the Athens (1981) earthquake natural experiment. Lancet. 1983;1(8322):441-444.CrossRefGoogle ScholarPubMed
7. Ogawa, K, Tsuji, I, Shiono, K, Hisamichi, S. Increased acute myocardial infarction mortality following the 1995 Great Hanshin-Awaji earthquake in Japan. Int J Epidemiol. 1996;29(3):449-455.CrossRefGoogle Scholar
8. Nakamura, A, Nozaki, E, Fukui, S, Endo, H, Takahashi, T, Tamaki, K. Increased risk of acute myocardial infarction after the Great East Japan Earthquake. Heart and Vessels. 2014;29(2):206-212.Google Scholar
9. Schwartz, BG, French, WJ, Mayeda, GS, et al. Emotional stressors trigger cardiovascular events. Int J Clin Pract. 2012;66(7):631-639.CrossRefGoogle ScholarPubMed
10. Sokejima, S, Nakatani, Y, Kario, K, Kayaba, K, Minowa, M, Kagamimori, S. Seismic intensity and risk of cerebrovascular stroke: 1995 Hanshin-Awaji earthquake. Prehosp Disaster Med. 2004;19(4):297-306.Google Scholar
11. Tsuchida, M, Kawashiri, M, Teramoto, R, et al. Impact of severe earthquake on the occurrence of acute coronary syndrome and stroke in a rural area of Japan. Circ J. 2009;73(7):1243-1247.Google Scholar
12. Sato, M, Fujita, S, Saito, A, et al. Increased incidence of transient left ventricular apical ballooning (so-called ‘Takotsubo’ cardiomyopathy) after the Mid-Niigata Prefecture Earthquake. Circ J. 2006;70(8):947-953.Google Scholar
13. Watanabe, H, Kodama, M, Okura, Y, et al. Impact of earthquakes on Takotsubo Cardiomyopathy. JAMA. 2005;294(3):305-307.Google Scholar
14. Zhang, XQ, Chen, M, Yang, Q, Yan, SD, Huang, DJ. Effect of Wenchuan Earthquake in China on hemodynamically unstable ventricular tachyarrhythmia in hospitalized patients. Am J Cardiol. 2009;103(7):994-997.CrossRefGoogle Scholar
15. Nakano, M, Kondo, M, Wakayama, Y, et al. Increased incidence of tachyarrhythmias and heart failure hospitalization in patients with implanted cardiac devices after the Great East Japan Earthquake disaster. Circ J. 2012;76(5):1283-1285.Google Scholar
16. Nakamura, A, Satake, H, Abe, A, et al. Characteristics of heart failure associated with the Great East Japan Earthquake. J Cardiol. 2013;62(1):25-30.CrossRefGoogle ScholarPubMed
17. Aoki, T, Fukumoto, Y, Yasuda, S, et al. The Great East Japan Earthquake Disaster and cardiovascular diseases. Eur Heart J. 2012;33(22):2796-2803.Google Scholar
18. Omama, S, Yoshida, Y, Ogasawara, K, et al. Influence of the Great East Japan Earthquake and tsunami 2011 on occurrence of cerebrovascular diseases in Iwate, Japan. Stroke. 2013;44(6):1518-1524.Google Scholar
19. Aoki, T, Takahashi, J, Fukumoto, Y, et al. Effect of the Great East Japan Earthquake on cardiovascular diseases. Circ J. 2013;77(2):490-493.CrossRefGoogle ScholarPubMed
20. Mustacchi, P. Stress and hypertension. West J Med. 1990;150(3):180-185.Google Scholar
21. Kario, K. Disaster hypertension – its characteristics, mechanism, and management. Circ J. 2012;76(3):553-562.Google Scholar
22. Nishizawa, M, Hoshide, S, Shimpo, M, Kario, K. Disaster hypertension: experience from the Great East Japan Earthquake of 2011. Curr Hypertens Rep. 2012;14(5):375-381.Google Scholar
23. Saito, K, Kim, JI, Maekawa, K, Ikeda, Y, Yokoyama, M. The Great Hanshin-Awaji earthquake aggravates blood pressure control in treated hypertensive patients. Am J Hypertens. 1997;10(2):217-221.Google Scholar
24. Minami, J, Kawano, Y, Ishimitsu, T, Yoshimi, H, Takishita, S. Effect of the Hanshin-Awaji earthquake on home blood pressure in patients with essential hypertension. Am J Hypertens. 1997;10(2):222-225.Google Scholar
25. Corrao, G, Parodi, A, Nicotra, F, et al. Better compliance to antihypertensive medications reduces cardiovascular risk. J Hypertens. 2011;29(3):610-618.Google Scholar
26. Statistics Japan. National census on October 1, 2010. Statistics Japan Web site. http://www.stat.go.jp/data/kokusei/2010/kihon1/pdf/gaiyou1.pdf. Accessed on December 28, 2014.Google Scholar
27. Rikuzentakata City. The situation of the damage of the Great East Japan Earthquake in Rikuzentakata city. Rikuzentakata City Web site. http://www.city.rikuzentakata.iwate.jp/shinsai/oshirase/hazard1.pdf. Accessed on February 20, 2015.Google Scholar
28. Rikuzentakata City. The verification report of the Great East Japan Earthquake by Rikuzentakata city. Rikuzentakata City Web site. http://www.city.rikuzentakata.iwate.jp/kategorie/bousai-syoubou/shinsai/shiryou.pdf. Accessed February 20, 2015.Google Scholar
29. Mancia, G, Fagard, R, Narkiewicz, K, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159-2219.Google Scholar
30. Tanida, N. What happened to elderly people in the great Hanshin earthquake. BMJ. 1996;313(7065):1133-1135.CrossRefGoogle ScholarPubMed
31. Kario, K, Matsuo, T, Ishida, T, Shimada, K. “White coat” hypertension and the Hansin –Awaji earthquake. Lancet. 1995;345(8961):1365.Google Scholar
32. Satoh, M, Kikuya, M, Ohkubo, T, et al. Acute and sub-acute effects of the Great East Japan Earthquake on home blood pressure values. Hypertension. 2011;58(6):e193-e194.Google Scholar
33. Dimsdale, JE, Moss, J. Plasma catecholamines in stress and exercise. JAMA. 1980;243(4):340-342.Google Scholar
34. Gangwisch, JE, Heymsfield, SB, Boden-Albala, B, et al. Short sleep duration as a risk factor for hypertension: analyses of the First National Health and Nutrition Examination Survey. Hypertension. 2006;47(5):833-839.CrossRefGoogle ScholarPubMed
35. Matsuo, T, Suzuki, S, Kodama, K, Kario, K. Hemostatic activation and cardiac events after the 1995 Hanshin-Awaji Earthquake. Int J Hematol. 1998;67(2):123-129.CrossRefGoogle ScholarPubMed
36. Doi, M, Takahashi, Y, Komatsu, R, et al. Salt-sensitive hypertension in circadian clock-deficient cry-null mice involves deregulated adrenal Hsd3b6. Nat Med. 2010;16(1):67-74.Google Scholar
37. Murakami, H, Akashi, H, Noda, S, et al. A cross-sectional survey of blood pressure of a coastal city’s resident victims of the 2011 Tohoku tsunami. Am J Hypertens. 2013;26(6):799-807.Google Scholar
38. Yamauchi, H, Yoshihisa, A, Iwaya, S, et al. Clinical features of patients with decompensated heart failure after the Great East Japan Earthquake. Am J Cardiol. 2013;112(1):94-99.CrossRefGoogle ScholarPubMed
39. Schaeffer, MA, Baum, A. Adrenal cortical response to stress at Three Mile Island. Psychosom Med. 1984;46(3):227-237.Google Scholar
40. Kitamura, T, Kiyohara, K, Iwami, T. The Great East Japan Earthquake and out-of-hospital cardiac arrest. N Engl J Med. 2013;369(22):2165-2167.CrossRefGoogle ScholarPubMed
41. Panizza, D, Lecasble, M. Effect of atenolol on car drivers in a prolonged stress situation. Eur J Clin Pharmacol. 1985;28(Suppl):97-99.CrossRefGoogle Scholar
42. Chierichetti, SM, Moise, G, Galeone, M, Fiorella, G, Lazzari, R. Beta-blockers and psychic stress: a double-blind, placebo-controlled study of popindolol vs lorazepam and butalbital in surgical patients. Int J Clin Pharmacol Ther Toxicol. 1985;23(9):510-514.Google Scholar
43. Watanabe, H, Kodama, M, Tanabe, N, et al. Impact of earthquakes on risk for pulmonary embolism. Int J Cardiol. 2008;129(1):152-154.CrossRefGoogle ScholarPubMed
44. Klatsky, AL, Fiedman, GD, Siegelaub, AB, Gérard, MJ. Alcohol consumption and blood pressure Kaiser-Permanente Multiphasic Health Examination data. N Engl J Med. 1977;296(22):1194-1200.CrossRefGoogle ScholarPubMed
45. Xin, X, He, J, Frontini, MG, Ogden, LG, Motsamai, OI, Whelton, PK. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2001;38(5):1112-1117.Google Scholar
46. Appel, LJ, Brands, MW, Daniels, SR, Karanja, N, Elmer, PJ, Sacks, FM. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension. 2006;47(2):296-308.CrossRefGoogle ScholarPubMed
47. Groppelli, A, Giorgi, DM, Omboni, S, Parati, G, Mancia, G. Persistent blood pressure increase induced by heavy smoking. J Hypertens. 1992;10(5):495-499.CrossRefGoogle ScholarPubMed
48. Powell, JT. Vascular damage from smoking: disease mechanisms at the arterial wall. Vasc Med. 1998;3(1):21-28.Google Scholar