Acute changes of blood pressure and heart rate induced by a strong earthquake

A high death toll during an earthquake comes not only from injuries related to the destruction of buildings or road accidents but also from sudden death resulting from cardiovascular problems, as clearly shown in reports.1,2 The increased rate of cardiovascular mortality during an earthquake has been ascribed to the impact of a major emotional stress on the heart, mediated through an increase in cardiac sympathetic activity,1,2 and probably including some other neuroendocrine mechanisms. A rise in blood pressure (BP) and heart rate (HR) may be directly responsible for the increased rate of cardiovascular mortality during an earthquake. Previously published studies about the acute changes of BP and HR used indirect information, usually collected after the events. A little direct information, such as by Parati et al,3 is not enough for the low-incidence rate of an earthquake and has the obvious technical difficulties in measuring BP during an earthquake. Luckily, we recorded the acute changes of BP and HR of some patients during the earthquake by 24-hour ambulatory blood pressure monitoring, as report below.