Stress suf­fer­ers take ter­ror­ism risk to heart

The Weekend Australian - Travel - - Health - Adam Cress­well Health Ed­i­tor

PEO­PLE who suf­fered se­vere stress af­ter the 9/11 ter­ror­ist at­tacks in 2001 suf­fered up to three times the nor­mal rate of heart at­tacks two years later — just from watch­ing the events on television. A study of nearly 3000 Amer­i­can cit­i­zens found rates of high blood pres­sure among those suf­fer­ing acute stress also dou­bled in the two years af­ter the at­tacks.

Over­all, rates of car­dio­vas­cu­lar prob­lems — rang­ing from high blood pres­sure to strokes and heart at­tacks — among those who suf­fered acute stress rose by 53 per cent com­pared to the gen­eral pop­u­la­tion over the three years fol­low­ing the at­tacks on the World Trade Cen­tre and Pen­tagon.

The find­ings, pub­lished this week in the US jour­nal Archives of Gen­eral Psy­chi­a­try (2008;65(1):73-80), chal­lenge pre­vi­ous as­sump­tions that peo­ple had to have had di­rect ex­po­sure to ter­ror­ist at­tacks, and the de­vel­op­ment of post-trau­matic stress dis­or­der, to suf­fer later phys­i­cal health prob­lems.

The find­ings were based on a rep­re­sen­ta­tive na­tional sam­ple of 2729 US adults, 95 per cent of whom had com­pleted an on­line health sur­vey be­fore the 2001 at­tacks.

Their acute stress re­sponses were recorded be­tween nine and 14 days af­ter the 9/11 at­tacks, and fol­low-up sur­veys counted the num­ber of di­ag­nosed heart prob­lems one, two and three years af­ter­wards.

The in­creases in rates of heart prob­lems were found even af­ter ad­just­ing the re­sults to take ac­count of prior car­dio­vas­cu­lar ill-health, other risk fac­tors in­clud­ing smok­ing and over­weight, how close peo­ple were to the at­tacks, and other fac­tors. The high­est in­crease in risk was seen in peo­ple who re­ported on­go­ing worry about ter­ror­ism in the years af­ter 9/11. The au­thors, from five lead­ing US univer­si­ties, said the find­ings fur­ther sug­gest The Week­end Health sec­tion has been ex­panded start­ing this week. Adam Taor’s col­umn, Body Parts You’ve Never Heard Of, ap­pears on Page 15. the im­por­tance of con­sid­er­ing the po­ten­tial pub­lic health im­pact of in­di­rect ex­po­sure to ex­treme stress, be­cause most of our re­spon­dents were ex­posed to the at­tacks only by watch­ing television’’.

To our knowl­edge, this is the first study to demon­strate that acute psy­cho­log­i­cal re­sponses to 9/11 pre­dicted in­creased in­ci­dence in re­ports of physi­cian-di­ag­nosed car­dio­vas­cu­lar ail­ments for three years in adults, most of whom did not have pre-ex­ist­ing car­diac dis­ease,’’ wrote the au­thors.

More­over, on­go­ing wor­ries about ter­ror­ism seemed to ex­ac­er­bate the risk of physi­cian-di­ag­nosed heart prob­lems two and three years later among in­di­vid­u­als with high 9/11-re­lated acute stress.’’

Gavin Lam­bert, head of the hu­man neu­ro­trans­mit­ters lab­o­ra­tory at Melbourne’s Baker Heart Re­search In­sti­tute, said the find­ings sup­ported pre­vi­ous re­search that ob­served a sim­i­lar in­crease in heart at­tacks in the weeks af­ter 9/11 in both New York and Florida — sug­gest­ing di­rect con­tact with the at­tacks was not re­quired to dam­age health.

How­ever, Lam­bert said it was un­likely the find­ings could be ex­trap­o­lated to peo­ple who watched TV re­ports of the Bali ter­ror­ist at­tacks of Oc­to­ber 2002, say­ing the two events were like chalk and cheese’’ as Bali re­ceived much less cov­er­age. The ef­fect no­ticed in the US study, where acute stress be­came longterm due to on­go­ing warn­ings and fears about re­peated ter­ror­ist at­tacks, also prob­a­bly would not ap­ply to Aus­tralia, where ter­ror threats have been less im­me­di­ate, Lam­bert said.

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