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Researchers from the Nagoya University's School of Medicine in Japan have recentlyimage dawn high blood pressure heart coronary disease hypertension ldl cholesterol stroke health information published, in the European Heart Journal, a paper entitled "Sudden Death in the Working Population; a Collaborative Study in Central Japan: Aim, Methods, Results, Conclusion." The focus was on stress on the job, stress from certain weekend activities and the correlation of stress with "sudden death. " Sudden death is defined as death occurring within the first hour of onset of symptoms. It accounts for over half of all deaths from acute myocardial infarction (heart attack).

The study included over 196,000 middle aged employees, all working in central Japan. The researchers' conclusion: "Mental stress, particularly that induced by changes in the social environment, seems to be a key factor (triggering sudden death) among persons in their prime." Of note is the fact that rates from the 1995 economic depression are more than double those of the 1991 economic boom.

Peak number of deaths occurred in the month of April, the start of the Japanese business year. Other peaks occurred on weekends and in the early morning hours. Only 17 percent of sudden deaths occurred in the workplace. The authors speculated that the practice of "binge drinking," along with "crowded resorts and roads" may be causative factors in the increased frequency of sudden deaths on weekends.

The authors noted other studies showing coronary artery spasm may be common in Japanese men of middle age and may account for the circadian late night or early morning patterns. Earlier studies have noted the incidence of coronary artery spasm is relatively high in Japanese compared to Caucasians. Coronary spasm occurs most frequently in times of rest, between midnight and early morning, and does not usually occur during daytime exercise.

During such spasms, the coronary artery smooth muscle may undergo sudden intense localized contraction, rupturing and extruding vulnerable plaque. This in turn may lead to angina, arrhythmia, acute myocardial infarction and/or sudden death. Cigarette smoking is a major risk factor. As a component in stabilizing heart rhythm and reducing the frequency of coronary artery spasm, the investigators recommended regular exercise.

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