Within 21 days of Hurricane Melissa: higher systolic blood pressure, diabetes, and heart failure vs age- and sex-matched community controls

Background Natural disasters are increasing globally, yet their cardiovascular consequences in Caribbean populations are poorly characterised. Hurricanes may provoke acute haemodynamic stress and unmask latent cardiometabolic disease. Purpose To compare cardiovascular risk profiles and comorbidities among survivors of Hurricane Melissa in a Caribbean setting with age- and sex-matched community controls derived from a regional electronic health record. Methods We prospectively collected clinical data within 21 days of Hurricane Melissa (immediately post-event) from 100 patients presenting with hurricane-related health needs in a Caribbean region. Age- and sex-matched controls (n=400; 1:4 ratio) were extracted from a regional electronic health record database using a Python-based algorithm that prioritised data completeness. We compared blood pressure, heart rate, body mass index (BMI), and major cardiovascular comorbidities between groups using descriptive statistics and appropriate comparative tests. Results The Hurricane Melissa cohort (mean age 51±21 years; 45% male) was demographically comparable to controls (52±23 years; 45% male; p=0.91). Systolic blood pressure was higher in disaster survivors than in controls (139±43 vs 132±18 mmHg; mean difference +7.6 mmHg; p=0.003). Diastolic blood pressure and heart rate were similar (83±15 vs 81±12 mmHg; p=0.32; and 81±15 vs 78±14 bpm; p=0.11, respectively). BMI did not differ between groups (39.7±18.4 vs 38.2±8.5 kg/m²; p=0.41). Diabetes mellitus was more prevalent among hurricane survivors (22% vs 15.5%; absolute difference +6.5%; p=0.042). Heart failure was documented in 5% of the disaster cohort versus <1% of controls (p=0.02). Hypertension prevalence was similar (47% vs 44.5%; p=0.58). Dyslipidaemia was more common in controls (21.3% vs 8%; p<0.001). Coronary artery disease prevalence did not differ (8% vs 7%; p=0.64). Conclusion(s) Survivors evaluated in the first 21 days after a major Caribbean hurricane had higher systolic blood pressure and greater burdens of diabetes and heart failure compared with age- and sex-matched community controls. These findings suggest hurricane exposure may rapidly amplify cardiovascular and metabolic risk and support the development of structured post-disaster cardiovascular screening pathways.