New Orleans residents continue to face a three-fold increased risk of heart attack post-Katrina-a trend that has remained unchanged since the storm hit in 2005, according to research being presented at the American College of Cardiology's 62nd Annual Scientific Session.
The new data-an update to previous analyses comparing the behavioral and heart health of people before and after the storm-show this heightened risk persists even though post-Katrina patients are more likely to be prescribed medications known to prevent heart attacks such as aspirin, beta blockers, statins and ACE inhibitors. Compared to the pre-Katrina group, those experiencing a heart attack after the storm were less likely to comply with these therapies 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.
"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. "These findings have broad implications about how natural disasters affect communities, as well as the extensive costs to society, whether it is financial or social."
Dr. Irimpen said the evidence supports an association 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. Previous studies indicate stress reduction and cognitive behavioral therapy, in particular, may reduce the occurrence of heart attacks.
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, which was five months after Katrina. Researchers examined differences in the incidence of heart attacks and compared the two groups based on specific demographic and clinical data, including lab test results, health insurance status, first-time hospitalization, medical non-adherence, smoking status, substance abuse and employment. In the post-Katrina group, there were 1,177 confirmed admissions for heart attack representing 2.4 percent of the total patient census of 48,258 compared to 150 admissions representing 0.7 percent of the patient census of 21,079 in the two-year pre-Katrina group (p<0.0001).