[StBernard] Tulane study finds threefold jump in post-Katrina heart attacks; stress blamed

Westley Annis westley at da-parish.com
Thu Mar 26 19:20:58 EDT 2009

Tulane study finds threefold jump in post-Katrina heart attacks; stress
by John Pope, The Times-Picayune
Thursday March 26, 2009, 4:43 PM
In the two years after Hurricane Katrina pummeled the New Orleans area,
Tulane University doctors found a threefold rise in heart attacks among
their patients, and they put the blame on continuing storm-related stress,
according to a study to be presented Sunday.

Calling this sustained rise in heart problems part of Katrina's "lingering
legacy," researchers found these patients showed post-storm increase in
factors that are evidence of stress, including homelessness, unemployment,
loss of insurance, smoking, poor eating habits, failure to take
prescriptions and living in temporary housing such as FEMA trailers.

Living under such conditions "creates a high stress level," said Dr. Anand
Irimpen, a Tulane cardiologist and one of the investigators.

Norman Morales can vouch for that. The Chalmette man, whose home was drowned
by floodwaters, suffered a heart atatck in January 2008 after enduring a
two-year odyssey that included time in shelters and a FEMA trailer.

"It was pure misery. .¤.¤. I would say the stress caused a lot of it,"
said Morales, whose case is part of the Tulane study. His treatment included
quintuple bypass surgery.

Although there has been a consensus that post-Katrina stress is responsible
for an array of health problems, "the only way to prove it was to collect
data and conduct a study," he said.

While the Tulane doctors were treating different patients after the storm,
their characteristics were "very similar," Irimpen said, explaining that
each group of men and women had similar rates of high blood pressure and
diabetes, which are two risk factors for heart attacks.

They were "well matched" for those two conditions, he said, as well as for
factors such as age and gender.

The risk factors that rose after the storm were cholesterol levels, which
Irimpen attributed to poor eating habits, and smoking.

The men and women the team studied probably were stricken because they were
too busy trying to put their lives back in order to pay attention to their
health, Irimpen said.

"For those of us in New Orleans, we know what the effects are," he said.
"You're constantly trying to get things done, people are still rebuilding,
and they have to get through the stress of getting contractors to come or
the workers to come on time. They're living in those homes and trying to get
to work and their regular activities."

"When you're caught in a situation like that, how helpless you feel,"
Morales, 64, said.

Researchers studied two groups of patients: 21,229 men and women who entered
Tulane's hospital from Aug. 29, 2003, to Aug. 28, 2005, the day before the
storm hit; and 11,282 people who were admitted from Feb. 14, 2006, the day
Tulane's hospital reopened, through Feb. 13, 2008.

Among the pre-Katraina patients, heart attacks struck 150 people -- 0.71
percent -- compared with 246 -- 2.18 percent -- among the people who were
hospitalized after the storm.

"We expected the increase," Irimpen said, "but I was a bit surprised by the
threefold increase. A threefold increase is very significant."

The study, which will be presented Sunday during the American College of
Cardiology's 58th annual Scientific Sessions in Orlando, Fla., is believed
to be the first to monitor disaster victims for such a long period.

In most cases, "disasters are over, and people move on," said Charles
Figley, a Tulane professor of social work who is a renowned scholar of
catastrophe and trauma. He was not part of the study.

"Here, there are so many people who were affected and for so long because
there was such widespread destruction," Figley said. "The Katrina effect
will be with us for a long time."

Studies the team consulted followed patients for only a short time, Irimpen
said, and most of them showed that stress-related problems abated relatively

"We were impressed to see that even more than two years after Katrina, there
was a significant increase in heart attacks," Irimpen said.

"Katrina keeps rewriting the textbooks," Figley said, "and this is another
chapter because there's nothing like it to compare with."

Originally, Irimpen said, he and his colleagues studied heart-attack data
from the first year after Tulane's hospital reopened.

Because they didn't see the typical post-storm dropoff in heart attacks that
they had expected, "we decided to follow the data and see what happened," he

To see if the trend has continued, Irimpen said the team intends to study
the year that ended last month and match it with data from another pre-storm

He also spoke of pooling the Tulane data with statistics from other area
hospitals to get a comprehensive picture of the effects of storm-related

Although researchers found increases in such risk factors as smoking and
substance abuse, Irimpen said they couldn't find one trend they had expected
to see: an increase in alcohol consumption.

The investigators found that stress afflicted more people than those who,
for instance, lost their homes or their jobs.

"You may not have been affected by Katrina," Irimpen said, "but every day,
you're dealing with people who have been affected by Katrina."

For instance, he said, "We had a contractor who came here to do work, and he
presented with a heart attack. He probably was going through a lot of
stress. We all think contractors have it easy, but some of those who take
their work seriously are under a lot of stress."

As a result of this research, Figley said, people need to take better care
of themselves to ward off such dire effects, even if they may think
everything is going well.

The study is "a clarion call," he said. "We can't assume everything's back
on track because our bodies don't lie."

Collaborating with Irimpen were Jonathan Menachem and Drs. Sandeep Gautam,
Sudesh Srivastav, and Patrice Delafontaine.

John Pope can be reached at jpope at timespicayune.com or at 504.826.3317.

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