title: Circadian variation of the onset of acute myocardial infarction in the Osaka area, 1998-1999: characterization of morning and nighttime peaks.
abstract: The onset of acute myocardial infarction (AMI) shows characteristic circadian variations; that is, a definite morning peak related to biologic rhythms and a vague nighttime peak related to socioeconomic factors. The recent economic recession in Japan may change the circadian variation, especially the nighttime peak. This study evaluated the recent circadian variation of AMI in Osaka and specified the patient subgroups showing either a morning or nighttime peak predominantly. Of 1,609 consecutive patients with AMI registered from April 1998 to January 2000, 1,252 whose onset of AMI was definitely identified were studied. The day was divided into six 4-h periods with a morning peak between 08.01 h and 12.00h, and nighttime peak between 20.01 h and 24.00h. When subgroup analysis was performed, female patients aged 65 years or more showed a morning peak alone and male patients aged less than 65 years with an occupation and the habits of cigarette smoking and alcohol intake showed a nighttime peak alone. Thus, in Osaka nighttime socioeconomic factors may currently be more potent triggers of AMI than the morning surges in younger male workers who smoke and drink.
authors.affiliation: Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kinjo
authors.forename: H
authors.initials: H
authors.lastname: Sato
authors.forename: H
authors.initials: H
authors.lastname: Sato
authors.forename: I
authors.initials: I
authors.lastname: Shiotani
authors.forename: T
authors.initials: T
authors.lastname: Kurotobi
authors.forename: Y
authors.initials: Y
authors.lastname: Ohnishi
authors.forename: E
authors.initials: E
authors.lastname: Hishida
authors.forename: D
authors.initials: D
authors.lastname: Nakatani
authors.forename: H
authors.initials: H
authors.lastname: Ito
authors.forename: Y
authors.initials: Y
authors.lastname: Koretsune
authors.forename: A
authors.initials: A
authors.lastname: Hirayama
authors.forename: J
authors.initials: J
authors.lastname: Tanouchi
authors.forename: M
authors.initials: M
authors.lastname: Mishima
authors.forename: T
authors.initials: T
authors.lastname: Kuzuya
authors.forename: H
authors.initials: H
authors.lastname: Takeda
authors.forename: M
authors.initials: M
authors.lastname: Hori
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000437:Alcoholism; D002940:Circadian Rhythm / Q000502:physiology*; D004467:Economics; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D012959:Socioeconomic Factors