Death certificates for 1992 of residents aged 20 years or older of southern Okinawa were surveyed for sudden death. A total of 359 probable sudden deaths were selected, and clinical and/or police records for 354 of the screened subjects were examined. By defining sudden death as unexpected non-traumatic natural death occurring less than 24 hours after the onset of the terminal episode, 68 cases of sudden death (6.7 % of all deaths) were confirmed. The crude annual incidence rate of sudden death was 0.55/1000 (0.67 in men, and 0.44 in women). Incidence rate increased with age. The causes of death were identified in only 35 cases, most of them being cardiovascular diseases. Subjects who died from strokes were younger than those from myocardial infarction. Regardless of cause of death, sudden death and a history of ischemic heart disease appeared to be associated. Hypertension and diabetes mellitus were more prevalent in sudden death from strokes or myocardial infarction than in control subjects, randomly selected from residents of Okinawa. However, cases with unknown death cause had prevalence rates of hypertension and diabetes mollitus that were similar to those in the control subjects. Thus, the risk profile for cases of sudden death of unknown cause may differ from that of sudden death victims who died of strokes or myocardial infarction.

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[in Japanese]

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Between 1987 and 1995, 56 sudden death cases, defined as unexpected death occurring within 24hours of onset, were found among 260, 424 male workers. These 56 sudden cases were studied in detail.
The annual age adjusted mortality was from 13.39 to 35.43 per 100, 000 persons. No increases were seen during the observation period.
The most frequent cause of sudden death was heart disease (57.1%), followed by cerebrovascular disease (26.8%).
Of mortality caused by heart disease, 13 cases had abnormalities on ECG during annual health examinations. For cerebral hemorrhage cases, 8 had high blood pressure in annual health examinations.
These results suggest the need for abnormal cases found during health examinations to be referred for medical treatment, and also the need for careful follow-up by health management staff to prevent sudden death.

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