JAMA network open · 2025
Hurricane Exposure and Risk of Long-Term Cardiovascular Disease Outcomes.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ghosh Arnab K, Soroka Orysya, Safford Monika, Shapiro Martin F, Wang Fei, Johnson Glen D, Civelek Yasin, DiMaggio Charles, Abramson David
Аннотация
IMPORTANCE: Hurricanes are associated with increased cardiovascular disease (CVD) risk, yet little is known about whether these risks extend into the long term and for how long.
OBJECTIVE: To examine the association between hurricane-related flooding and CVD risk up to 5 years after landfall.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study included a 20% national sample of continuously enrolled Medicare fee-for-service beneficiaries from New Jersey, New York City, and Connecticut from January 1, 2010, to December 31, 2017. Data were analyzed from December 14, 2023, to June 20, 2025.
EXPOSURE: Residence in zip code tabulation areas (ZCTAs) impacted by flooding from Hurricane Sandy throughout the study period.
MAIN OUTCOMES AND MEASURES: The primary outcome was the rate of ZCTA-level adjusted CVD events (including myocardial infarction [MI], heart failure [HF], and stroke), defined per 1000 beneficiary-years, with associated 95% bayesian credible intervals (bCrIs). Secondary outcomes included the rate of events for each CVD subtype (MI, HF, and stroke).
RESULTS: In the matched cohort, 121 395 beneficiaries resided in 690 ZCTAs, of which 441 (63.9%) flooded. In nonflooded vs flooded ZCTAs, mean (SD) age (74.2 [1.4] vs 74.1 [1.2] years; P = .16), proportion of female beneficiaries (61.4% [8.4%] vs 61.3% [6.6%]; P = .89), and proportion of White beneficiaries (74.3% [28.7%] vs 76.7% [26.8%]; P = .27) were similar, but ZCTA-level median income ($81 168 [$33 410] vs $69 650 [$27 594]; P < .001) and median National Area Deprivation Index rank (17.1 [IQR, 10.2-27.6] vs 21.0 [IQR, 10.9-32.5]; P = .02) differed; prevalence of CVD and CVD subtypes was similar at baseline. Flooding was associated with an increase in adjusted 5-year CVD risk post landfall (relative risk, 1.05; 95% bCrI, 1.01-1.08) and HF rates overall (relative risk, 1.03; 95% bCrI, 1.00-1.08). No significant difference was found in rates of MI or stroke in adjusted analyses.
CONCLUSIONS AND RELEVANCE: In this cohort study of Medicare fee-for-service beneficiaries, hurricane-related flooding was associated with increases in CVD event rates as long as 5 years after landfall and increased HF rates in New Jersey. These findings highlight the importance of place-based vulnerability from hurricane exposure to mitigate longer-term CVD risk and the need to consider long-term outcomes in hurricane mitigation efforts.
OBJECTIVE: To examine the association between hurricane-related flooding and CVD risk up to 5 years after landfall.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study included a 20% national sample of continuously enrolled Medicare fee-for-service beneficiaries from New Jersey, New York City, and Connecticut from January 1, 2010, to December 31, 2017. Data were analyzed from December 14, 2023, to June 20, 2025.
EXPOSURE: Residence in zip code tabulation areas (ZCTAs) impacted by flooding from Hurricane Sandy throughout the study period.
MAIN OUTCOMES AND MEASURES: The primary outcome was the rate of ZCTA-level adjusted CVD events (including myocardial infarction [MI], heart failure [HF], and stroke), defined per 1000 beneficiary-years, with associated 95% bayesian credible intervals (bCrIs). Secondary outcomes included the rate of events for each CVD subtype (MI, HF, and stroke).
RESULTS: In the matched cohort, 121 395 beneficiaries resided in 690 ZCTAs, of which 441 (63.9%) flooded. In nonflooded vs flooded ZCTAs, mean (SD) age (74.2 [1.4] vs 74.1 [1.2] years; P = .16), proportion of female beneficiaries (61.4% [8.4%] vs 61.3% [6.6%]; P = .89), and proportion of White beneficiaries (74.3% [28.7%] vs 76.7% [26.8%]; P = .27) were similar, but ZCTA-level median income ($81 168 [$33 410] vs $69 650 [$27 594]; P < .001) and median National Area Deprivation Index rank (17.1 [IQR, 10.2-27.6] vs 21.0 [IQR, 10.9-32.5]; P = .02) differed; prevalence of CVD and CVD subtypes was similar at baseline. Flooding was associated with an increase in adjusted 5-year CVD risk post landfall (relative risk, 1.05; 95% bCrI, 1.01-1.08) and HF rates overall (relative risk, 1.03; 95% bCrI, 1.00-1.08). No significant difference was found in rates of MI or stroke in adjusted analyses.
CONCLUSIONS AND RELEVANCE: In this cohort study of Medicare fee-for-service beneficiaries, hurricane-related flooding was associated with increases in CVD event rates as long as 5 years after landfall and increased HF rates in New Jersey. These findings highlight the importance of place-based vulnerability from hurricane exposure to mitigate longer-term CVD risk and the need to consider long-term outcomes in hurricane mitigation efforts.