Accelerated Carotid Atherosclerosis Following Earthquake Exposure: Results from Jidong Women Cohort

OBJECTIVE: The cardiovascular impact of earthquakes remains poorly understood, particularly regarding subclinical vascular diseases in women. This study examined the association between seismic exposure and the progression of carotid atherosclerosis in northern Chinese adults. METHODS: A totally of 7,412 individuals were enrolled, including survivors of the 1976 Tangshan earthquake (magnitude 7.8) and unexposed controls. Carotid atherosclerosis was assessed using bilateral ultrasonography. Multivariate logistic regression accounted for sociodemographic, clinical, and lifestyle covariates. RESULTS: Among females, earthquake exposure was associated with significantly higher atherosclerosis prevalence (44.9% vs. 33.1% in males), with elevated adjusted odds ( OR = 2.32, 95% CI: 1.78-3.02, P < 0.001). No significant association was observed in males after full adjustment. In women, CVD risk increased twofold (95% CI: 1.66-2.55, P < 0.001), with gradients by age (≥ 65 years: HR = 3.98, P < 0.001), education (elementary: HR = 4.00, P < 0.001), and income (low-income: HR = 2.74, P < 0.001). Proximity to the epicenter further amplified the CVD risk (log-rank P < 0.0001). CONCLUSION: Seismic exposure independently predicts accelerated carotid atherosclerosis and cardiovascular risk in women, underscoring the need to elucidate sex-specific mechanisms and develop targeted interventions for post-disaster populations.