Abstract 13090: Autonomic Dysfunction Exacerbates New-Onset Heart Failure in Patients with Hypertension after the 2011 Great East Japan Earthquake
Introduction: We and others have reported that the occurrence of heart failure (HF) increased after the Great East Japan Earthquake on March 11, 2011, but the association of hypertension with HF remains unclear. In Minamisoma City, located approximately 20 km north of the Fukushima Daiichi Nuclear Power Plant, we hypothesized that autonomic dysfunction due to chronic stressful conditions may be associated with new-onset HF in patients with essential hypertension.
Methods: We studied 110 outpatients (63 males, mean age 73 years) with essential hypertension in Minamisoma Municipal General Hospital. Holter monitoring was performed between July, 2011 and March, 2012 to evaluate standard deviation of all R-R intervals (SDNN) and standard deviation of the 5-min mean R-R intervals (SDANN). During the follow-up period (20.8 ± 4.5 months) under anti-hypertensive therapy, there were 7 hospitalizations due to new-onset HF and 1 sudden cardiac death. With the exception of sudden cardiac death, study subjects were divided into two groups based on whether new-onset HF occurred (n=7, HF) or not (n=102, no HF). We compared systolic and diastolic blood pressures, SDNN and SDANN between two groups.
Results: Although there were no differences in systolic and diastolic blood pressures, SDNN and SDANN were significantly lower in HF than in no HF (SDNN: 92.5 ± 30.0 ms vs. 139.2 ± 44.9 ms; SDANN: 83.4 ± 27.8 ms vs. 127.6 ± 43.8 ms, P<0.01, respectively). Based on the receiver operating characteristic analyses for new-onset HF, cut-off values of SDNN and SDANN were defined as < 94.0 ms and < 77.5 ms, respectively. Kaplan-Meier analyses demonstrated that event-free rates from new-onset HF were lower in patients with low SDNN and in those with low SDANN (P<0.01, respectively) as shown in Figure.
Conclusions: These results suggest that autonomic dysfunction plays an important role in new-onset HF after catastrophic disasters in patients with hypertension.
Author Disclosures: S. Yamada: None. H. Suzuki: None. T. Misaka: None. H. Mizukami: None. K. Sugimoto: None. S. Saitoh: None. F. Suzuki: None. Y. Takeishi: None.
- © 2014 by American Heart Association, Inc.