Dietary habits, intake of nutrients, and results of health examinations for 676 local government officers aged from thirty to sixty-four years were analyzed during the period of March 1990 to February 1991, and compared for workers living separately from their families due to their job, and those living with their families.
The following results were obtained;
1. The prevalence of having poor dietary habits, such as not eating breakfast or lunch, and late night eating, was higher in the workers living away from their families than those living with their families.
2. For subjects having body mass index (BMI) exceeding 25, intakes of total energy, fat and vitamin B2 was greater for workers living away from their families than those living with their families. For those with BMI less than 25, intake of vitamin A in workers living away from their families was lower, but other nutrients were identical.
3. Among Participants with BMI exceeding 25, levels of serum GOT, serum cholesterol and systolic blood pressurs were higher in workers living apart from their families. For those with BMI under 25, there was no difference between two groups.
These results show that dietary habits and intake of nutrients differed between workers living away from, and those living with their families, especially in those workers with BMI exceeding 25.

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The occurrence of stroke and acute myocardial infarction (AMI) was studied using hospital-based stroke and AMI registration data from the western part of Shiga prefecture between April 1988 and December 1991. Further, the subsequent physical disability after onset was studied using data from a longterm follow-up study of activities of daily living (ADL) for registered patients.
Subject entry criteria for the study was in accordance with criteria established in “Studies on Registration, Management, and Follow-up Monitoring System for Cardiovascilar Disease” a reserch supported by the Ministry of Health and Welfare. Follow-up procedures for the ADL study were also in accordance with the guidelines established by the above research group.
Over a four-year period 316 stroke patients and 45 AMI patients were registered. The ratio of stroke to AMI was 7 : 1 which was higher than those found in other surveyed areas. The ratio of cerebral infarction to cerebral hemorrhage was 3.1 : 1. This ratio was slso higker than those reported in other recent studies. In the 5th and 6th decade of life, the occurrence of stroke in men was about twice that in women.
In 11.2% of stroke cases and in 25% of AMI cases, patient death occurred within 28 days of diseae onset. From the follow-up study of ADL, at an average of 1.7 years after disease onset, total physical disability was found in 15.3% of patients with cerebral infarction, and in 7.4% of patients with cerebral hemorrhage, resulting in total physical disadility being about two times higher in cerebral infarction cases than cerebral hemorrhage cases.
As the aging population increase steadily, the number of persons with total physical disability as a result of stroke-related diseases will probably also increase in the future. In order to reduce the number of physically disabled seniors in the population, it is important to prevent the occurrence of stroke. While including all high risk age-groups for stroke and their younger counterparts should specially be targeted for stroke prevention education. intervention measures should include the identification, assessment, and elimination of risk factors associated with stroke in the population. In particular, it is very important to reduce the risk of stroke among middle-aged men.

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To investigate the role of mental and physical stress as a trigger in the occurrence of acute myocardial infarction, a case-control study was performed using as cases male coronary atherosclerotic patients, aged 60 years or younger, diagnosed by coronary angiography and consisted of 58 cases of acute myocardial infarction (AMI) and 86 cases of chronic coronary diseases (CCD). For each patient, two age-matched healthy males were chosen mainly from post office workers as the controls. informations related to stress during the week prior to hospitalization or examination, were obtained by interview. Multiple logistic regression analysis was performed, adjusting for the effects of other risk factors, and odds ratio (OR) and its 95% confidence intervals (CI) associated with each item related to stress were obtained.
In comparison with controls, a competitive personality was shown to have a significantly elevated ORs for AMI (OR : 12.2, CI : 3.740.7) and CCD (OR : 7.6, CI : 3.416.8). An association with stressful situation was also found to be significant for both groups (OR for AMI : 5.6, CI : 1.7-18.1 ; and OR for CCD : 8.2, CI : 3.618.8). However, the OR associated with decreased sleeping hours was significant only for AMI (OR : 3.9, CI : 1.114. 8) and not for CCD. When the ORs of occurrence of AMI associated with these stress related items were obtained by comparison with CCD matched with respect to coronary atherosclerosis, only decreased sleeping hours was a significant factor (OR : 3.2, CI : 1.19.3).
From these results, it is concluded that although stress was related to the development of coronary atherosclerosis, a decrease in sleeping hours, probably a reflection of an abrupt increase in stress and/or a decrease in rest time to diminish such stress, appears to operate as the trigger in the occurrence of acute myocardial infarction.

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Factors related to hypertension were analysed for 761 male and 749 female subjects, not receiving antihypertensive treatment, aged 40 to 69 in 1989 in Tanushimaru.
Factors related to hypertension were analysed by step-wise multiple logistic regression analysis. In males, drinking habit, age, and elevated glycosylated hemoglobin Aic (>6.0%) were shown to be significantly correlated with systolic blood pressure (≥160mmHg), while body mass index (≥25kg/m²) and hyperuricemia (≥7.0mg/ dl) were correlated with diastolic blood pressure (≥95mmHg).
No significant relationships were observed in females, except for age and high glycosylated hemoglobin A_1C. Glycosylated hemoglobin A_1C had a high relative risk (R. R. : 2.37, 95%C. I : 1.30-4.29) for high systolic blood pressure over 160mmHg in males. In females, also, high glycosylated hemoglobin A_1C had an elevated relative risk (R. R. : 2.94, 95%C. I : 1.36-6.35) for high systolic blood pressure over 160mmHg, and, in addition, had a high relative risk (R. R. : 3.12, 95% C. I : 1.22-7.97) for high diastolic blood pressure over 95mmHg.
These results show that glucose intolerance is closely related to hypertension.

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Periodic health examinations for employees have been modified for early detection of coronary, cerebrovascular prone-subjects with or without coronary risk factors. From a ten-year overview of cause of death in local government employees, myocardial infarct death appears to have decreased. However, cardiac sudden death or acute cardiac failure has increased similar to other developed countries. Circadian variation of cardiovascular death was clear, i. e. the frequency of stroke and cardiovascular death was higher between 6 to 8 a. m. than at other times of the day possibly due to circadian rhythms in vascular tone, vasoconstriction, blood pressure, blood-coagulation, etc. as has been reported elsewhere. Moreover, CVD death was more frequent on Mondays or on the day after a holiday than on other days. The causal mechanisms may be a lack of warming-up of the neuroendocrine system, poor adaptation to resumption of work, or due to a carry-over of fatigue due to overexertion on the day off.
Total health promotion programs for office workers, consisting of a well-organized health examination with educational programs needed not only for individuals unedr medical care, but also for healthy individuals. Health promotion or fitness programs for preclinical or healthy workers need to be developed, with individual medical and physical data stored in computer files to provide useful information for health promotion programs.

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Therapeutic interventions in hypertensive patients were assessed based on results of a long-term follow-up study of 2, 164 unselected consecutive clinical cases with essential hypertension. They had been treated almost continuously with available depressor agents and successfully followed for 30 years or until death.
Twenty-one factros generally cossidered as risk factors of hypertension were subjected to multiple regression analyses to determine prognostic factors. Among these factors age, sex and hypertensive or arteriosclerotic organ damage were established as prognostic factors, while initial diastolic blood pressure and serum cholesterol level were not. It was notable that initially noted obesity was revealed to be an independent predictor of long-term survival by such analyses.
In this study, hypertensive organ damage was concluded to be a more important factor in the management of hypertensive patients than the level of blood pressure, and therefore, a simple and useful clinical classification of severity of hypertension based on hypertesive organ damage should be constructed and made widely available for use in daily treatment.

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