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The circadian pattern of ischaemic heart disease events in Indian population

S R Mehta1, S Das, S D Karloopia

  • 1Army Hospital (Referral and Research), Delhi Contt.-110010.

The Journal of the Association of Physicians of India
|March 7, 2001
PubMed

Insights

Ischaemic heart disease (IHD) events show a distinct circadian rhythm, peaking in the morning hours (6 a.m. to 12 p.m.). This pattern holds across various IHD subgroups, suggesting morning triggers for cardiovascular events.

Area of Science:

  • Cardiology
  • Chronobiology
  • Epidemiology

Background:

  • Previous research indicates a higher incidence of ischaemic heart disease (IHD) events in the morning.
  • Understanding the daily pattern of IHD onset is crucial for preventative strategies.

Purpose of the Study:

  • To investigate the circadian variation in the onset of various ischaemic heart disease (IHD) manifestations in an Indian population.
  • To identify specific IHD subgroups that exhibit this morning peak.

Main Methods:

  • A retrospective analysis of 605 patients with confirmed IHD events (acute Q-wave myocardial infarction, unstable angina, non-Q myocardial infarction, acute pulmonary oedema, sudden cardiac death).
  • Data collected included patient demographics, medical history, medications, and the time of event onset.
  • Statistical analysis was performed to determine the distribution of IHD events across different quarters of the day.

Main Results:

  • Overall, 33.55% of IHD events occurred between 6 a.m. and 12 p.m., confirming a significant morning peak (p < 0.0001).
  • This circadian rhythm was consistent across males, females, younger patients (<60 years), and those without a prior IHD history.
  • Specific subgroups like acute Q-wave myocardial infarction, unstable angina, and sudden cardiac death showed a pronounced morning incidence, while acute pulmonary oedema peaked in the evening (4th quarter).
  • Diabetic patients and those with a past history of IHD did not exhibit a significant circadian pattern.

Conclusions:

  • The study confirms a circadian pattern in IHD manifestations in the Indian population, similar to global findings.
  • Morning hours (6 a.m. to 12 p.m.) appear to be a critical period for IHD events, likely due to prominent transient precipitating risk factors.
  • Further research into these morning triggers and pathophysiological changes could aid in IHD prevention.

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