New Orleans cardiologist Dr. Anand Irimpen began to notice that his on-call nights at the hospital were getting busier soon after the devastation wrought by Hurricane Katrina. It seemed as if many more people were having heart attacks.
He decided to examine the data, and he discovered it wasn’t a fluke. The number of heart attack hospital admissions was three times higher than before the storm, and has not abated, not even ten years later.
“Stress contributes to heart attacks, and we had a major disaster that disrupted the whole city,” he says. “Still, we were surprised, because we didn’t expect a three-fold increase. We were expecting a slight increase, followed by a decrease. But ten years out, we are still seeing a three-fold increase.”
Irimpen, chief of cardiology at Southeast Louisiana Veterans Health Care System and professor of medicine at Tulane University, said many of his patients have spoken to him of their struggles, both from the direct effects of the hurricane, as well as about later obstacles they encountered when trying to rebuild their homes.
“Some were evacuated and are now just coming back, others have told me that they have only just started to rebuild because they got their [insurance] money late,” he says. “With climate change, we are seeing an increase in extreme weather events all around the world, and it’s important for us to understand how these factors affect the heart.”
Heart disease is the leading cause of death in the United States. More than half a million people annually experience their first heart attack, and about 200,000 have a second one, according to the American Heart Association.
Irimpen presented his research today at a scientific meeting sponsored by the heart association.
“It is well-known that those types of social and psychosocial conditions are related to cardiovascular events,’’ says Dr. Richard C. Becker, a spokesman for the heart association and director of the University of Cincinnati Heart, Lung and Vascular Institute. “We’ve recognized for many years that there is an acute stress response that can lead to sudden cardiac death, heart attack and stroke.
“During Hurricane Katrina, there were a million people that were displaced,” Becker added. “These are individuals who likely had underlying high blood pressure, diabetes or other risk factors, who may not have had access to either their medications or to a healthcare provider. This is a very important observational study.”
Irimpen and his colleagues also found that patients were significantly more likely to have other risk factors for heart attack post-Katrina than before the hurricane, including coronary artery disease, diabetes, high blood pressure and high cholesterol. They were also more likely to be smokers.
The researchers found that these patients were more than twice as likely to abuse drugs, or suffer from a psychiatric disease as their pre-Katrina counterparts. Moreover, unemployment and lack of health insurance were significantly more frequent among the post-Katrina patients, he says.
Post-Katrina patients also were more likely to receive prescriptions for medications to treat heart disease, cholesterol and hypertension, but were only half as likely to take them compared to the pre-Katrina group, he says.
“When the priority is rebuilding your home, health often takes a back seat,’’ Irimpen says. “A lot of them are not taking their medications, not eating at home — eating out and eating unhealthy food — and they may be pushed to high risk activities, like smoking and substance abuse. They are still dealing with the effects of a major disaster that has disrupted healthy living styles.”
Some, he adds, may have had an existing predisposition to heart disease “that reached a tipping point because of the devastation and related stress of Katrina, and they didn’t know it themselves.”
The researchers studied 150 hospital records for heart attack patients admitted to Tulane Medical Center in the two years before Katrina, and 2,341 in the ten years after.
Irimpen plans to expand the study to two other hospitals in the city, University Medical Center and Touro Hospital, to gain a more complete picture of post-Katrina heart attacks in the city. He hopes to have results in about a year.
“My thinking is that it will show a similar increase,” he says. “My hope as a cardiologist is that it does not, but my expectation as a scientist is that it will.”
Marlene Cimons writes for Nexus Media, a syndicated newswire covering climate, energy, policy, art, and culture.