biostudies-literatureUnknown8(9)Ghosh AK<h4>Importance</h4>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.<h4>Objective</h4>To examine the association between hurricane-related flooding and CVD risk up to 5 years after landfall.<h4>Design, setting, and participants</h4>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.<h4>Exposure</h4>Residence in zip code tabulation areas (ZCTAs) impacted by flooding from Hurricane Sandy throughout the study period.<h4>Main outcomes and measures</h4>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).<h4>Results</h4>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.<h4>Conclusions and relevance</h4>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.JAMA network opene2530335https://www.ebi.ac.uk/biostudies/studies/S-EPMC12409596biostudies-literatureHurricane Exposure and Risk of Long-Term Cardiovascular Disease Outcomes.PMC12409596Soroka OCivelek YDiMaggio CShapiro MFWang FAbramson DJohnson GDSafford MGhosh AKfalseHurricane Exposure and Risk of Long-Term Cardiovascular Disease Outcomes.<h4>Importance</h4>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.<h4>Objective</h4>To examine the association between hurricane-related flooding and CVD risk up to 5 years after landfall.<h4>Design, setting, and participants</h4>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.<h4>Exposure</h4>Residence in zip code tabulation areas (ZCTAs) impacted by flooding from Hurricane Sandy throughout the study period.<h4>Main outcomes and measures</h4>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).<h4>Results</h4>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.<h4>Conclusions and relevance</h4>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.2025-01-01T00:00:00Z2025 Sep2026-05-29T21:18:16.684Z2026-04-08T05:59:12.187ZS-EPMC124095964090059010.1001/jamanetworkopen.2025.30335