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Circadian variation in cardiovascular events
1Gill Heart Institute, University of Kentucky College of Medicine, Lexington 40536, USA.
Insights
Serious cardiovascular events like heart attack and stroke peak in the morning due to circadian rhythms. This review explores the evidence, physiology, and pharmaceutical implications of this daily pattern in thrombotic processes.
Area of Science:
- Cardiovascular Medicine
- Chronobiology
- Epidemiology
Background:
- Serious adverse cardiovascular events (e.g., myocardial infarction, stroke) are often linked to thrombotic processes and atherosclerotic plaque rupture.
- These events display significant circadian rhythmicity, with a notable increase in the morning hours.
Purpose of the Study:
- To review epidemiologic evidence of circadian patterns in cardiovascular events.
- To explore the physiological mechanisms underlying this phenomenon.
- To discuss implications for pharmaceutical development and clinical practice.
Main Methods:
- Literature review of epidemiologic studies on cardiovascular event timing.
- Analysis of physiological factors contributing to morning cardiovascular events.
- Discussion of clinical and pharmaceutical implications.
Main Results:
- Cardiovascular events, including myocardial infarction and stroke, show a distinct peak in the morning hours.
- The review examines the evidence supporting this circadian phenomenon and its potential physiological drivers.
- The implications for understanding plaque rupture and developing targeted therapies are considered.
Conclusions:
- The morning peak in cardiovascular events is a well-documented circadian phenomenon.
- Understanding the physiological underpinnings is crucial for developing effective preventive strategies.
- This pattern has significant implications for rational pharmaceutical development and timing of interventions.
Abstract:
Serious adverse cardiovascular events, including myocardial infarction, sudden cardiac death, and stroke, frequently result from thrombotic processes and rupture of atherosclerotic plaques. These events exhibit a pronounced circadian rhythmicity, with a marked peak in the morning hours when the patient assumes an upright posture and begins daily activities. However, it is not known if plaques rupture more frequently in the morning. This review will examine the epidemiologic evidence documenting this circadian phenomenon, consider its physiologic underpinnings, and discuss the implications of this pattern for rational pharmaceutical development. Finally, some practical implications regarding potential triggers of cardiovascular events will be discussed.