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Q&A: Expert explores the link between natural disasters, stress and heart disease
Between global hurricanes and the California wildfires, the number of natural disasters has been high in 2017.
Recent research suggests a correlation between natural disasters and increased rates of MI.
Cardiology Today recently discussed the link between natural disasters and cardiac health with William H. Frishman, MD, MPH, director of medicine at Westchester Medical Center and the Rosenthal Professor and chairman of the department of medicine at New York Medical College.
Question: What is the connection between stress and heart disease? What does the literature say about it?
Answer: It is well known that emotional stress can bring on various heart problems, especially in patients with cardiac histories. These problems include MI, hypertension, arrhythmia and HF. Extreme stress can also bring on takotsubo cardiomyopathy, also known as broken heart syndrome, where patients without underlying heart disease can develop HF.
The literature has shown the relationship between stress and heightened sympathetic nerve activity with the occurrence of cardiac disorders.
Q: How can cardiologists help their patients manage stress?
A: There are various approaches to relieving stress, including biofeedback, psychotherapy and medications. I have found that patients with hyperkinetic circulations — paroxysmal rises in BP and heart rate — will respond to treatment with beta-blockers with relief of anxiety and sympathetic nervous system overstimulation.
We are all exposed to stressful situations every day and the secret is learning how to deal with it. Cardiologists play a major role in this process through supportive interactions with patients.
Q: What effects do natural disasters have on stress and heart disease?
A: There is literature showing the effects of natural disasters and the resultant stress on heart disease. Just after 9/11, there was a rise in CV events in New York City thought to be related to chronic stress. During the first Gulf War, Iraq launched missiles into Israel, and during this period, the frequency of CV events including MI were increased in older Israelis. Natural disasters can bring on the same complications. It would be of interest to examine cardiac complications after the recent storm in Puerto Rico.
Q: How can cardiologists treat and manage heart and CV conditions during and after natural disasters?
A: Cardiologists should be making sure that high-risk patients with cardiac disease are in a safe area during a natural disaster, and they should be available for patient emergencies.
Q: What further research needs to be done in these areas?
A: Research needs to be done on the best ways to protect against the consequences of stress, especially in patients with known cardiac disease and in those individuals at risk.
For more information:
can be reached at william_frishman@nymc.edu.
Disclosure: Frishman reports no relevant financial disclosures.