Abstract:

About 20,000 people died or disappeared due to the direct effects of the Great East Japan Earthquake (9.0 on the Richter scale) and tsunami on March 11, 2011. Secondary damage occurred in Fukushima, due to an accident at a nuclear power plant. Acute or chronic psychological stress caused by major disasters is a significant trigger of sudden death due to cardiac causes. This increase is thought to be the result of increased blood pressure (BP). In Fukushima and nearby prefectures, BP transiently increased in patients with or without chronic kidney disease (CKD), which was consistent with several reports about previous disasters. In particular, BP significantly increased in patients with and without CKD who lived in coastal regions and/or near the nuclear power plant, compared with those who lived elsewhere. Sympatholytics, such as α- and β-blockers ameliorated the elevation in BP. These findings suggest that activation of the sympathetic nervous system after the earthquake caused the increases in BP. However, adding other antihypertensive drugs to control BP or ameliorating physiological stress through evacuation from the quake affected area was almost impossible due a lack of supplies including medicines and severe infrastructural damage. Hence, more intensive and appropriate physiological management might be needed after major disasters to prevent cardiovascular events arising due to BP elevation until BP returns to baseline.