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BACKGROUND Seasonal and circadian variations in the occurrence of myocardial infarction and sudden cardiac death have been documented, suggesting that triggering factors may play a role in the causation of cardiac events. However, there are only sparse and conflicting data on the weekly distribution of the disorders. METHODS AND RESULTS To determine the weekly variation of acute myocardial infarction and sudden cardiac death, 5596 consecutive patients (71% men; age, 63 +/- 1 years) were analyzed in a regionally defined population (n = 330,000; age, 25 to 74 years) monitored from 1985 to 1990. The exact time of onset of symptoms was used to determine the day of the event. Patients with myocardial infarction (n = 2636) demonstrated a significant weekly variation (P < .01) with a peak on Monday, whereas patients with sudden cardiac death (n = 2960) were evenly distributed throughout the week. A similar weekly pattern was observed in subgroups of patients with myocardial infarction defined with respect to age, sex, cardiac risk factors, prior cardiac medication, and infarct characteristics. The working population demonstrated a weekly variation of myocardial infarction as opposed to the nonworking population, with a 33% increase in relative risk of disease onset on Monday (P < .05) and a trough on Sunday compared with the expected number of cases, if homogeneity was assumed. CONCLUSIONS The onset of acute myocardial infarction demonstrates a peak on Monday primarily in the working population. If this finding is confirmed in other communities, it may aid in identifying acute triggering events of myocardial infarction and perhaps in improving prevention of the disease. (Copyright © 1994 by American Heart Association)
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BACKGROUND: Recent studies have highlighted the role of right-sided anterior temporal and prefrontal activation during anxiety, yet no study has been performed with social phobics that assesses regional brain and autonomic function. This study compared electroencephalograms (EEGs) and autonomic activity in social phobics and controls while they anticipated making a public speech. METHODS: Electroencephalograms from 14 scalp locations, heart rate, and blood pressure were recorded while 18 DSM-IV social phobics and 10 controls anticipated making a public speech, as well as immediately after the speech was made. Self-reports of anxiety and affect were also obtained. RESULTS: Phobics showed a significantly greater increase in anxiety and negative affect during the anticipation condition compared with controls. Heart rate was elevated in the phobics relative to the controls in most conditions. Phobics showed a marked increase in right-sided activation in the anterior temporal and lateral prefrontal scalp regions. These heart rate and EEG changes together accounted for > 48% of the variance in the increase in negative affect during the anticipation phase. CONCLUSIONS: These findings support the hypothesis of right-sided anterior cortical activation during anxiety and indicate that the combination of EEG and heart rate changes during anticipation account for substantial variance in reported negative affect.
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