title: The Great East Japan Earthquake Disaster and cardiovascular diseases.
abstract: OBJECTIVE
  While previous studies reported a short-term increase in individual cardiovascular disease (CVD) after great earthquakes, mid-term occurrences of all types of CVDs after great earthquakes are unknown. We addressed this important issue in our experience with the Great East Japan Earthquake (11 March 2011).
  
  
  RESULTS
  We retrospectively examined the impact of the Earthquake on the occurrences of CVDs and pneumonia by comparing the ambulance records made by doctors in our Miyagi Prefecture, the centre of the disaster area, during the periods of 2008-11 (n = 124,152). The weekly occurrences of CVDs, including heart failure (HF), acute coronary syndrome (ACS), stroke, cardiopulmonary arrest (CPA), and pneumonia were all significantly increased after the Earthquake compared with the previous 3 years. The occurrences of ACS and CPA showed the rapid increase followed by a sharp decline, whereas those of HF and pneumonia showed a prolonged increase for more than 6 weeks and those of stroke and CPA showed a second peak after the largest aftershock (7 April 2011). Furthermore, the occurrence of CPA was increased in the first 24 h after the Earthquake, followed by other diseases later on. These increases were independent of age, sex, or residence area (seacoast vs. inland).
  
  
  CONCLUSIONS
  These results indicate that the occurrences of all types of CVDs and pneumonia were increased in somewhat different time courses after the Earthquake, including the first observation of the marked and prolonged increase in HF, emphasizing the importance of intensive medical management of all types of CVDs after great earthquakes.
authors.affiliation: Department of Cardiovascular Medicine,  Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8575,  Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Aoki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fukumoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sakata
authors.forename: Kenta
authors.initials: K
authors.lastname: Ito
authors.forename: Jun
authors.initials: J
authors.lastname: Takahashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miyata
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsuji
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimokawa
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology*; D004190:Disasters / Q000706:statistics & numerical data*; D055866:Earthquakes / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology; D012189:Retrospective Studies