Disaster-related Stress as a Prospective Risk Factor for Hypertension in Parents of Adolescent Fire Victims

Abstract

Life stress has been related to hypertension in various studies, but well-designed research carried out in disaster settings is scarce. Moreover, most research focuses on the primary victims and disregards effects on their caregivers. In a prospective, population-based cohort study, the authors tested the hypothesis that parents of adolescents who had been involved in the Volendam, Netherlands, pub fire on January 1, 2001 (n = 418) were more at risk of developing hypertension than parents from the same community whose children had not been involved in the fire (n = 1,462). Only residents without prior evidence of hypertension were included. The follow-up period covered 4 years (2001-2004). Assessment of hypertension was based on the records of family practitioners and pharmacies. The odds of developing new hypertension were 1.48 times higher in parents of fire victims than in control parents during the follow-up period (odds ratio = 1.48, 95% confidence interval: 1.09, 2.02). All analyses controlled for age, gender, socioeconomic status, family practice, history of chronic disease, and number of contacts with the family practitioner during follow-up. Since hypertension is an important risk factor for cardiovascular morbidity, it is important to provide interventions that help people fight the negative effects of disaster-related stress.

How do the Psychosocial Factors Affect Blood Pressure in Patients with Hypertension? A Cross-Sectional Study

“…A study in South Africa suggested that self-reported diagnosis of hypertension is more common among those with anxiety disorders, depressive disorders and comorbid anxiety-depression compared to those without a mental disorder [10]. Our findings about having controlled blood pressure is harder in the presence of psychological factors and mental disorders such as anxiety and depression were consistent with those of the several studies [11][12][13][14][15]. Rutledge and Hogan reported an overall increased hypertension risk among anxious subjects although the hypertension risk did not reach significance.…”

Does psychosocial stress cause hypertension? A systematic review of observational studies

“…The association between acute stress and hypertension was evaluated in only three studies, 8,12,13 which had inconsistent results. The case-control study showed an inverse association in men and women, 8 but the probability of a recall bias cannot be ruled out.…”

“…One of the cohort studies showed a null association 12 and the other a positive association. 13 From the studies of chronic stress, five reported at least one significant risk for hypertension among several measures of stress, 8,9,14,15,18 and two were negative. 16,17 The positive studies had a mean average score of quality of 6.6, in comparison with a score of 7.5 for the two studies with negative findings.…”

“…The distinction of acute and chronic stress was in some way arbitrary, as some acute events have long-lasting repercussion. An example is the study by Dorn et al, 13 who studied parents of adolescent fire victims. This acute stressful event definitely has a long-lasting duration.…”

“…Another potential limitation of the cohort studies was the losses in follow-up, which varied from 0 to 68%. Studies that presented original analysis had fewer losses, 12,13,14,16,17 which were higher in reanalysis, mostly because of incomplete data. 8,15,[18][19][20] There was no trend for an association between the proportion of losses and the estimates of risk.…”