Earthquakes literally broke hearts in New Zealand

(Reuters Health) - Heart attacks spiked in Christchurch, New Zealand in the areas struck hardest by a set of 2010 and 2011 earthquakes during the year after the tremblers, a new study shows.

Middle-aged and older residents of the areas with the most property damage suffered 25 percent more cardiovascular-related deaths than their neighbors in Christchurch with the least damage in the year after the Canterbury earthquakes, the research found.

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At the same time, residents of the most-damaged areas were 22 percent more likely to be admitted to hospitals for heart attacks than their neighbors in the least-damaged areas.

Senior author Vicky Cameron saw the toll the earthquakes took on the health of her friends and neighbors as more than 12,000 aftershocks rattled their homes and their nerves for more than two years, she said in a Skype interview.

“A lot of people in my community were dealing with long-term stress and quite a long period of chronic stress,” said Cameron, a professor of medicine at the University of Otago in Christchurch. “Our study suggests it’s not just the shaking people experience, but the long-term impacts on their lives, if they lose their homes.”

She witnessed the strain some earthquake victims experienced as a result of protracted negotiations with insurance companies over the cost of repairing and replacing damaged buildings.

Cameron and her team linked insurance claims data to data on health outcomes to examine 148,000 residents who were at least 45 years old and living in the Christchurch region during the 2010 and 2011 earthquakes, they report in The Lancet Planetary Health.

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Aftermath of New Zealand earthquake

Evacuees formerly stranded in the earthquake-affected town of Kaikoura stand alongside the helicopter that brought them to the town of Woodend, near Christchurch, New Zealand, November 16, 2016.

(REUTERS/Lincoln Feast)

Earthquake damage to State Highway 1 is seen south of Kaikoura on November 16, 2016. Rescue efforts after a devastating earthquake in New Zealand intensified on November 16 as a fleet of international warships began arriving in the disaster zone.

(MARTY MELVILLE/AFP/Getty Images)

A huge dam formed by a landslide as a result of the 7.5 earthquake, on the Clarence River north of Kaikoura on November 14, 2016 in New Zealand. The 7.5 magnitude earthquake struck 20km south-east of Hanmer Springs and triggered tsunami warnings for many coastal areas.

(Photo by Mark Mitchell - Pool/Getty Images)

Evacuees formerly stranded in the earthquake-affected town of Kaikoura stand alongside the helicopter that brought them to the town of Woodend, near Christchurch, New Zealand November 16, 2016.

(REUTERS/Lincoln Feast)

A buried vehicle tunne on State Highway 1 from the November 14 earthquake is seen south of Kaikoura on November 16, 2016. Rescue efforts after a devastating earthquake in New Zealand intensified on November 16 as a fleet of international warships began arriving in the disaster zone.

(MARTY MELVILLE/AFP/Getty Images)

A damaged car is towed by a breakdown mechanic at the scene where a man crashed his car into the sea on November 16, 2016 in Christchurch, New Zealand. A medical incident is to believed to have caused a man to drive his car off road, into the Avon-Heathcote Estuary. He is reported to be in hospital and no others were involved in the incident.

(Photo by KAI SCHWOERER/Getty Images)

Local residents Chris and Viv Young look at damage caused by an earthquake along State Highway One, south of the township of Blenheim on New Zealand's South Island, November 14, 2016.

(REUTERS/Anthony Phelps)

Products lie on the ground in a chemist after an earthquake on November 14, 2016 in Wellington, New Zealand. The 7.5 magnitude earthquake struck 20km south-east of Hanmer Springs and triggered tsunami warnings for many coastal areas.

(Photo by Hagen Hopkins/Getty Images)

Waiwhetu Stream swells with flood water after a bout of severe weather on November 15, 2016 in Wellington, New Zealand. Wellington has been hit by torrential rain and gale-forced winds in the wake of the earthquakes, which killed two people.

(Photo by Hagen Hopkins/Getty Images)

A strong after-shock brings a huge slip tumbling down a Valley in the Kaikoura Range on November 14, 2016 in New Zealand. The 7.5 magnitude earthquake struck 20km south-east of Hanmer Springs and triggered tsunami warnings for many coastal areas.

(Photo by Mark Mitchell - Pool/Getty Images)

The Waiau Lodge Hotel, in Waiau, 120 kms north of Christchurch, shows damage in the aftermath of a 7.5 magnitude earthquake on November 14, 2016 in Waiau, New Zealand. The 7.5 magnitude earthquake struck 20km south-east of Hanmer Springs and triggered tsunami warnings for many coastal areas.

(Photo by Matias Delacroix/Getty Images)

The Waiau Lodge Hotel, in Waiau, 120 kms north of Christchurch, shows damage in the aftermath of a 7.5 magnitude earthquake on November 14, 2016 in Waiau, New Zealand. The 7.5 magnitude earthquake struck 20km south-east of Hanmer Springs and triggered tsunami warnings for many coastal areas.

(Photo by Matias Delacroix/Getty Images)

Rotherham Road, 110 kms north of Christchurch, shows damage and land slip in the aftermath of a 7.5 magnitude earthquake on November 14, 2016 in Waiau, New Zealand. The 7.5 magnitude earthquake struck 20km south-east of Hanmer Springs and triggered tsunami warnings for many coastal areas.

(Photo by Matias Delacroix/Getty Images)

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People living in the most damaged houses were most at risk for heart attacks for a year after the jolts, the researchers found.

They found no evidence for increased cardiovascular disease beyond the first year.

The Canterbury earthquake sequence began on September 4, 2010 with a magnitude 7.1 quake. A quake measuring 6.3 on the Richter scale and centered in Christchurch followed on February 22, 2011. The seismic activity killed 185, injured 6,000 and damaged 170,000 buildings.

Previous research has established that stress-induced cardiovascular problems can be seen for a year following earthquakes, an accompanying editorial points out. The new study focused on areas with the worst property damage compared to those with the least.

Homeowners and tenants in highly damaged areas had to find places to relocate in a region with limited housing options and consequently hiked rental prices, the authors write.

Cameron speculated that having to move while having to negotiate with insurance companies might have combined to add sufficient stress on residents to increase cardiovascular disease.

Dr. Boback Ziaeian, a cardiologist and clinical instructor at the University of California, Los Angeles, said healthcare providers and hospitals should be prepared for small increases in hospitalizations for cardiovascular conditions after natural disasters.

“Rates of heart attack go up after big sports matches, especially for men at high risk,” he said by email. “After earthquakes specifically, we see the same increase in cardiovascular events.”

Hospitalization rates for acute heart attacks tripled in a New Orleans hospital in the six years after Hurricane Katrina, a previous study found.

“Helping people transition to secure housing and employment as part of a continued relief effort are important to reducing possible long-term health effects of environmental stressors,” said Ziaeian, who was not involved with the study.

Cardiovascular disease may increase following disasters because people coping with the fallout are struggling to care for themselves, he said.

“They end up smoking to deal with stress, don't take their medications as well, have worse blood pressure and that's why we see an association between natural disasters and long-term increases in cardiovascular disease,” he said.

The best medicine for preventing cardiovascular disease following disasters is the same as at any other time, Ziaeian said.

“While we do not know how to prevent earthquakes, we do know how to prevent heart attacks with a combination of lifestyle changes and medical therapies,” he said.

SOURCES: http://bit.ly/2wU7okR and http://bit.ly/2xJw8jS The Lancet Planetary Health, online September 7, 2017.

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