Elsevier

The Lancet

Volume 321, Issue 8322, 26 February 1983, Pages 441-444
The Lancet

PSYCHOLOGICAL STRESS AND FATAL HEART ATTACK: THE ATHENS (1981) EARTHQUAKE NATURAL EXPERIMENT

https://doi.org/10.1016/S0140-6736(83)91439-3Get rights and content

Abstract

The effects of acute and subacute psychological stress caused by a sudden general disaster on mortality from atherosclerotic heart disease (underlying cause) and cardiac events (proximate cause) were investigated by comparing total and cause-specific mortality during the days after a major earthquake in Athens in 1981 with the mortality during the surrounding month and the corresponding periods of 1980 and 1982. There was an excess of deaths from cardiac and external causes on the days after the major earthquake, but no excess of deaths from cancer and little, if any, excess of deaths from other causes. The excess mortality was more evident when atherosclerotic heart disease was considered as the underlying cause (5, 7, and 8 deaths on the first three days, respectively; background mean deaths per day 2·6; upper 95th centile 5) than when cardiac events in general were considered as the proximate cause (9, 11, and 14 deaths on the first three days, respectively; background mean 7·1, upper 95th centile 12).

References (30)

  • Cd Jenkins

    Recent evidence supporting psychologic social risk factors for coronary disease

    N Engl J Med

    (1976)
  • Rh Rahe

    Stress and strain in coronary heart disease

    J S Carolina Med Assoc

    (1976)
  • S. Jacobs et al.

    An epidemiological review of the mortality of bereavement

    Psychosom Med

    (1977)
  • A. Myers et al.

    Circumstances attending 100 sudden deaths from coronary artery disease with coroner's necropsies

    Br Heart J

    (1975)
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