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A distressing childhood can lead to heart disease. What about current stresses, longer workouts, threats of layoffs, and collapsing pension funds? A study last year in the Lancet examined more than 11 000 heart attack sufferers from 52 countries. It found that in the year before their heart attacks, patients had been under significantly more strains than some 30 000 healthy control subjects. Those strains came from work, family, financial troubles, depression and other causes. "Each of these factors was individually associated with increased risk," says Doctor Salim Yosef, Professor of medicine at Canada's McMaster University and senior investigator of the study. Together, they accounted for 30% of overall heart attack risks. But people respond differently to high-pressure work situations. Whether it produces heart problems seems to depend on whether you have a sense of control over life or live at the mercy of your circumstances and superiors. That was experiences of John Connell, a roughed Illinois laboratory manager, who suffered his first heart attack in 1996 at the age of 56. In the two years before, his mother and two of his children had suffered serious illnesses, and his job had been changed in a re-organization. "My life seemed completely out of control," he said, "I had no idea where I would end up." He ended up in hospital due to a block in his artery. Two months later, he had a triple by-pass surgery. A second heart attack when he was 58 left his doctor shaking his head. "There's nothing more we can do for you," doctors told him.