The Great East Japan Earthquake Disaster and Cardiovascular Diseases

List of Authors: Hiroaki Shimokawa, MD, PhD; Tatsuo Aoki, MD, PhD; Yoshihiro Fukumoto, MD, PhD.Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

While previous studies reported short-term increase in individual cardiovascular disease (CVD) after great earthquakes, mid-term occurrences of all types of CVDs after great earthquakes are unknown. We addressed this important issue in our experience with the Great East Japan Earthquake (March 11, 2011).

Methods and Results
We retrospectively examined the impact of the Earthquake on the occurrences of CVDs and pneumonia by comparing the ambulance records made by doctors in our Miyagi prefecture, the center of the disaster area, during the periods of 2008-2011 (n=124,152). The weekly occurrences of CVDs, including heart failure (HF), acute coronary syndrome (ACS), stroke and 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).

These results indicate that the occurrences of all types of CVDs and pneumonia were increased in somewhat different time-courses after the Earthquake, including the first observation of the marked and prolonged increase in HF, emphasizing the importance of intensive medical management of all types of CVDs after great earthquakes.