Evidence regarding the effect of psychological factors and evacuation on cardiovascular disease occurrence after large-scale disasters is limited. This prospective study followed up a total of 37,810 Japanese men and women aged 30–89 years from the Fukushima Prefecture with no history of stroke or heart disease at baseline (2012), until 2017. This period included 3000 cardiovascular events recorded through questionnaires and death certificates. The participants’ psychological distress, trauma reaction, and evacuation status were defined, and divided into four groups based on combinations of psychological factors and evacuation status. We calculated the hazard ratios and 95% confidence intervals for only psychological, only evacuation, or both of them compared with neither using Cox proportional hazard models. Psychological factors along with evacuation resulted in approximately 5% to 25% higher magnitude of stroke and heart disease risk than psychological factors only among men. Compared to neither, the multivariable hazard ratios of those with both psychological distress and evacuation were 1.75 for stroke and 1.49 for heart disease, and those of both trauma reaction and evacuation were 2.01 and 1.57, respectively, among men. Evacuation combined with psychological factors increased the risk of stroke and heart disease risks especially in men after the Great East Japan Earthquake.

中文翻译：

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东日本大地震后心理因素与疏散状况和心血管疾病发生率的关联：福岛市健康管理调查的前瞻性研究

关于心理因素和疏散对大规模灾难后心血管疾病发生的影响的证据有限。这项前瞻性研究随访了截至2017年的福岛县30,89岁年龄在30-89岁的日本男性和女性，基线时无中风或心脏病史（2012年），截至2017年。此期间包括3000例通过问卷调查和死亡的心血管事件证书。定义参与者的心理困扰，创伤反应和疏散状态，并根据心理因素和疏散状态的组合将其分为四组。我们只使用心理疏散，仅疏散疏散或同时计算两者的危险比和95％置信区间，而不使用Cox比例危险模型。心理因素和疏散导致的中风和心脏病风险比仅男性心理因素高约5％至25％。相比之下，男性中心理困扰和疏散者的多变量危险比分别为1.75和1.49；心脏病和疏散者的多变量危险率分别为2.01和1.57。疏散与心理因素相结合会增加中风和心脏病风险，尤其是在东日本大地震后的男性中。男性的心脏病发病率分别为2.01和1.57，分别为49和1.57。疏散与心理因素相结合会增加中风和心脏病风险，尤其是在东日本大地震后的男性中。男性的心脏病发病率分别为2.01和1.57，分别为49和1.57。疏散与心理因素相结合会增加中风和心脏病风险，尤其是在东日本大地震后的男性中。