title: Evacuation and Risk of Hypertension After the Great East Japan Earthquake: The Fukushima Health Management Survey.
abstract: On March 11, 2011, the Great East Japan Earthquake occurred in Japan, with a nuclear accident subsequently occurring at the Fukushima Daiichi Nuclear Power Plant. The disaster forced many evacuees to change particular aspects of their lifestyles. This study assessed the hypothesis that evacuation may have increased the risk of hypertension among residents in Fukushima. A longitudinal study examined data collected from 31 252 Japanese participants aged 40 to 74 years sourced from general health checkups conducted in 13 communities between 2008 and 2010. Follow-up examinations were conducted from 2011 through 2013. A total of 21 989 participants (follow-up proportion, 70.4%) received follow-up examinations. Mean blood pressure significantly increased in both evacuees and nonevacuees after the disaster, with greater changes in blood pressure among the former. The changes in systolic and diastolic blood pressure among the evacuees and nonevacuees were +5.8/3.4 versus +4.6/2.1 mm Hg (P<0.01/P<0.0001) for men and +4.4/2.8 versus +4.1/1.7 mm Hg (P=0.33/P<0.0001) for women, respectively. Evacuation was associated with an increased risk of hypertension among men, and the age-adjusted hazard ratios of evacuation for incidence of hypertension were 1.24 (95% confidence interval, 1.11-1.39; P<0.001) for men and 1.05 (95% confidence interval, 0.94-1.17; P=0.37) for women, respectively. For men, after adjustment for confounding variables, the hazard ratio slightly decreased to 1.20, but the association was essentially unchanged. Blood pressure increased among residents, especially evacuees, in the evacuation zone of Fukushima prefecture after the Great East Japan Earthquake. Evacuation may be associated with an increased risk of hypertension among men in the 2 years after the disaster.
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.). teoohira@fmu.ac.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ohira
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Hosoya
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasumura
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Satoh
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Akira
authors.initials: A
authors.lastname: Sakai
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Akira
authors.initials: A
authors.lastname: Ohtsuru
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Kawasaki
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Kotaro
authors.initials: K
authors.lastname: Ozasa
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Gen
authors.initials: G
authors.lastname: Kobashi
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Shigeatsu
authors.initials: S
authors.lastname: Hashimoto
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Kenji
authors.initials: K
authors.lastname: Kamiya
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: From the Radiation Medical Science Center for the Fukushima Health Management Survey (T.O., M.H., S.Y., H. Satoh, H. Suzuki, A.S., A.O., Y.K., A.T., S.H., K.K., S.Y., M.A.) and Department of Public Health School of Medicine (S.Y.), Fukushima Medical University, Japan; Department of Epidemiology (T.O.), Department of Pediatrics (M.H., Y.K.), Department of Diabetology, Endocrinology, and Metabolism (H. Satoh), Department of Cardiology and Hematology (H. Suzuki), Department of Radiation Life Sciences (A.S.), Department of Radiation Health Management (A.O.), and Department of Gastroenterology and Rheumatology (A.T.), Fukushima Medical University School of Medicine, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan (K.O.); Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan (G.K.); Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan (K.K.); and Atomic Bomb Disease Institute, Nagasaki University, Japan (S.Y.).
authors.forename: Masafumi
authors.initials: M
authors.lastname: Abe
mesh_terms: D000328:Adult; D001795:Blood Pressure Determination; D016001:Confidence Intervals; D018450:Disease Progression; D055866:Earthquakes; D060447:Emergency Shelter / Q000458:organization & administration; D005260:Female; D062406:Fukushima Nuclear Accident; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology*; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D016016:Proportional Hazards Models; D018635:Rescue Work / Q000458:organization & administration*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology; D015996:Survival Rate
keywords: blood pressure; cardiovascular disease; disaster; hypertension; prospective study