Management of cardiovascular risk in disaster: Jichi Medical School (JMS) proposal 2004

There is growing evidence that psychological stress contributes to cardiovascular disease. In proportion to the damage of the disaster, the number of cardiovascular events increases in a high-risk older population. Typical increase was found during nighttime, suggesting that poor sleep quality might affect disaster-induced cardiovascular events. Acute stress can trigger cardiovascular events predominantly through sympathetic nervous activation and potentiation of acute risk factors (blood pressure increase, endothelial cell dysfunction, increased blood viscosity, and platelet and hemostatic activation). Chronic stress resulting from environmental change contributes to the atherosclerotic process through the neuroendocrine and immune systems (sympathetic nervous system and hypothalamus-pituitary adrenal axis) and related chronic risk factors (metabolic syndrome, hypertension, diabetes, and hyperlipidemia). In this Jichi Medical School (JMS) Proposal 2004, we propose the practical management of disaster-induced risk factor and stress, and hope immediate management could achieve effective primary and secondary prevention for cardiovascular disease in disaster.