World Crises Trigger More Heart Attacks

Heart attack risk linked to stressful world events such as Hurricane Katrina

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) When this world starts to get you down, it could be increasing your risk of heart attack. New studies have found that hurricanes, war and economic crises may be bad for the heart.

At this year’s annual meeting of the American College of Cardiology (ACC) in San Francisco, a series of studies highlighted how world events can harm heart health.

New Orleans residents have faced a three-fold increased risk of heart attack after Hurricane Katrina. Heart attacks in Greece have spiked as the economy has plunged. Veterans with PTSD are now also battling heart disease and diabetes.

"Find ways to relieve stress to improve heart health."

Anand Irimpen, MD, 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, led the investigation, which evaluated patients admitted with heart attacks to Tulane Medical Center in the two years before Katrina and and five months after Katrina.

Dr. Irimpen and his colleagues discovered that 1,177 patients were admitted for heart attack post-Katrina. This represented 2.4 percent of the total patient census of 48,258. In the pre-Katrina group, there were 150 admissions for heart attack, representing 0.7 percent of the patient census of 21,079.

Dr. Irimpen said the evidence supports a link between pervasive levels of chronic stress and heart health and underscores the need for clinicians to proactively assess their patients’ anxiety levels, especially in the aftermath of such a traumatic event.

In Greece, scientists analyzed data on 22,093 patients admitted to the cardiology department of the General Hospital of Kalamata over an eight-year span. Patients were divided into groups representing the pre-financial crisis period from January 2004 through December 2007 or the crisis period from January 2008 through December 2011.

Heart attack incidence shot up after the financial meltdown, with 1,084 heart attacks during the crisis compared with 841 pre-crisis.

“Unemployment is a stressful event and stress is connected with heart disease, but other issues also come with financial difficulties,” said Emmanouil Makaris, MD, a consulting cardiologist at Kalamata’s General Hospital. “In these times, a lot of people do not have money to buy medications or to go to their primary care doctor. There’s a great increase in cardiovascular diseases across the country. The cost to the society is very high.”

Another study presented at the ACC conference on March 10 focused on how PTSD (post-traumatic stress disease) aggravated heart disease and diabetes. This could affect many veterans returning from the wars in Iraq and Afghanistan.

This retrospective study included 207,954 veterans in Southern California and Nevada between 46 and 74 years of age (93 percent male) with and without PTSD. All subjects had no known history of heart disease or diabetes.

Scientists followed patients for an average of two years to see whether they developed insulin resistance, a characteristic of diabetes, which contributes to hardening of the arteries and increases the risk of heart attack.

Researchers also evaluated the subjects for metabolic syndrome, a cluster of conditions including increased blood pressure, high blood sugar levels, excess body fat and abnormal cholesterol levels that increase the risk of heart disease, diabetes and stroke.

Investigators noted that insulin resistance was significantly higher in PTSD participants, with 35 percent showing resistance compared to 19 percent without PTSD.

Similarly, metabolic syndrome was significantly more likely in the PTSD group, with 53 percent having the syndrome compared to 38 percent in the non-PTSD population.

Ramin Ebrahimi, MD, professor of medicine at University of California Los Angeles and a co-lead investigator on the study, told dailyRx News, “Our initial research established an association between PTSD and atherosclerotic coronary artery disease. This subsequent trial points to an association between PTSD and some of the precursors of atherosclerosis and diabetes."

Dr. Ebramini added, "PTSD is not only a disorder associated with veterans and can happen to anyone. Clinicians in general should be more vigilant in terms of looking for this diagnosis in their patients who have been victims of stressful situations."

These studies were presented on March 10 at the American College of Cardiology’s annual scientific meeting in San Francisco. Studies presented at scientific meetings have yet to be published in a peer-reviewed journal. As such, the findings should be considered preliminary.

Reviewed by: 
Review Date: 
March 12, 2013
Last Updated:
March 15, 2013