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Friday, 21 December, 2001, 00:54 GMT
Killer number 'unlucky for heart patients'
monitor
Fatal heart attacks were more common on the fourth
A superstitious fear of the number four could be proving fatal for some Chinese and Japanese people, says a study.

Heart deaths peak in these communities on the fourth of the month, and it is suggested that the psychological stress which grips some people on this date may be partly to blame.

Researchers from the University of California at San Diego examined the death certificates of more than 200,000 Japanese former American residents.


At present, the only explanation consistent with the findings is that psychological stress linked to the number four elicits additional deaths

Report authors
They found that deaths from chronic heart disease were 13% more likely on the fourth, compared to other days.

The average number of deaths among Chinese and Japanese people on the fourth was 90, compared to just over 60 on other days of the month.

This peak was higher among Japanese and Chinese Californians, who were 27% more likely to succumb on the fourth.

Sounds like death

Some Chinese and Japanese people find the number four distressing - as it sounds almost exactly like the word "death" in Mandarin, Cantonese and Japanese.

Some Chinese and Japanese hospitals do not list a fourth floor or put four on the doors of any room.

The researchers wrote: "At present, the only explanation consistent with the findings is that psychological stress linked to the number four elicits additional deaths among Chinese and Japanese patients."


It may be due to chance, or perhaps these communities must take these superstitions very seriously indeed

Prof John McMurray
University of Glasgow
Alternative explanations did exist - but little evidence could be found to support them.

They suggested that on the fourth of the month, patients might refuse medicines, change their diets, or start drinking more because of their worries.

However, as the effect was even larger among inpatients in hospital - who would have little opportunity to do these - this explanation does not appear to be true.

Stress link

Other studies have suggested a link between major psychological stresses and increased cardiac mortality.

An investigation of medical records in a town in the US revealed a peak in heart deaths around the time of an earthquake.

One UK study found that cardiac deaths were more likely on a Monday than any other day of the week - but suggested much of this effect was due to the results of binge drinking over the weekend catching up on the patient.

Professor John McMurray, an expert in cardiology who runs the Heart Failure Research Group at University of Glasgow, said that he would expect stress would have to be extreme to provoke results of this kind.

He said: "It may be due to chance, or perhaps these communities must take these superstitions very seriously indeed."

The research was published in the British Medical Journal (BMJ).

 WATCH/LISTEN
 ON THIS STORY
Prof David Phillips of UCLA, California
"The Japanese and Chinese pronounce 'four' in the same way they pronounce 'death'
Dr Hugh Montgomery from UCL Hospital
"The science behind this is very good indeed"
See also:

22 Aug 01 | Health
Weekend heart risk for young men
25 Jun 01 | Health
Stress: The effects
20 Jan 00 | Health
Mondays 'bring heart attacks'
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