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Holocaust Survival and the Long-term Risk of Cardiovascular Disease in the Elderly
Nadya Kagansky1, Hilla Knobler2,3, Marina Stein-Babich1
1Sherutei Briut Clalit (Clalit Health Services), Central region, Israel.
Insights
Holocaust survivors (HS) show higher rates of cardiovascular disease (CVD) and ischemic heart disease (IHD), yet many live long lives, indicating resilience and effective coping mechanisms.
Area of Science:
- Cardiology
- Gerontology
- Psychotraumatology
Background:
- Conflicting reports exist on Holocaust survivors' (HS) longevity versus chronic disease prevalence.
- Long-term cardiovascular disease (CVD) risk data in HS are limited.
- Clinical data on HS exposed to severe persecution are scarce.
Purpose of the Study:
- To assess CVD prevalence and risk factors in elderly HS compared to non-Holocaust survivors (NHS).
Main Methods:
- Retrospective observational study using Clalit Health Services data.
- Compared 4004 elderly HS with 4004 matched elderly NHS.
- Analyzed CVD prevalence and risk factors.
Main Results:
- HS were older, with 51% over 85 years.
- Significantly higher prevalence of ischemic heart disease (IHD) in HS.
- HS underwent more cardiac interventions (20% vs. 15.7%) and HS status was an independent risk factor for IHD.
Conclusions:
- Despite higher CVD prevalence, many HS achieve longevity, suggesting resilience.
- This resilience may stem from coping abilities and tailored medical care.
- Findings can inform treatment strategies for mass trauma survivors.
Background:
Reports of longevity in Holocaust survivors (HS) conflict with excess prevalence of chronic diseases described among them. However, data on their long-term risk of cardiovascular diseases (CVD) are limited. Clinical data on large representative groups of HS who were exposed to severe persecution are also limited.
Objectives:
To determine the prevalence of CVD and the risk factors in a large cohort of elderly HS compared to elderly individuals who were not exposed to the Holocaust (NHS).
Methods:
CVD prevalence rates and risk factors data from the computerized system of the central district of Clalit Health Services, the largest Israeli health maintenance organization (HMO) in Israel were evaluated in a retrospective observational study. The study was comprised of 4004 elderly HS who underwent direct severe persecution. They were randomly matched by identification numbers to 4004 elderly NHS.
Results:
HS were older than NHS and 51% of them were older than 85 years. The prevalence rate of ischemic heart disease (IHD) was significantly higher among HS. HS underwent significantly more cardiac interventions (20% vs. 15.7%, P < 0.05). HS status was an independent risk factor for increased IHD and for more coronary interventions.
Conclusions:
Despite having a higher prevalence of CVD, a substantial number of HS live long lives. This finding may imply both unique resilience and ability to cope with chronic illness of the survivors as well as adjusted medical services for this population. These findings may help in planning the treatment of other mass trauma survivors.
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