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Circadian pattern of cardiovascular and cerebrovascular diseases in geriatric population

A Bhalla1, A Sood, M Mahapatra

  • 1Department of Medicine, GMC and Hospital, Chandigarh.

The Journal of the Association of Physicians of India
|March 1, 2002
PubMed

Insights

Geriatric patients exhibit circadian variations in cardiovascular and cerebrovascular events, with peaks observed in the morning and evening. This study highlights distinct temporal patterns for acute coronary syndromes and strokes in the elderly Indian population.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • Circadian variations in cardiovascular and cerebrovascular diseases are documented in adults.
  • Limited data exists on these patterns in the geriatric population, particularly in India.

Purpose of the Study:

  • To investigate circadian patterns of acute myocardial infarction (AMI), unstable angina (USA), non-Q wave MI (non-QMI), cerebrovascular accidents (CVA), and transient ischemic attacks (TIA) in geriatric patients.
  • To identify specific time-of-day peaks for these events in the elderly Indian population.

Main Methods:

  • A prospective observational study was conducted with 158 geriatric patients (mean age 69 years) at Government Medical College and Hospital, Chandigarh.
  • The 24-hour period was divided into four equal quarters for analysis of event occurrences.
  • Patients presented with AMI (34.17%), CVA (34.17%), USA (22.78%), non-Q MI (7.59%), and TIA (2 patients).

Main Results:

  • A significant circadian variation was observed, with a primary peak in episodes between 6 am and 12 noon (36.71%) and a secondary peak between 6 pm and 12 midnight (25.31%).
  • The period between 12 midnight and 6 am had the fewest events (13.92%).
  • Specific patterns included dual peaks for AMI and CVA, and a single peak for USA.

Conclusions:

  • Geriatric patients demonstrate a clear circadian variation in cardiovascular and cerebrovascular events.
  • Two comparable peaks were identified: one in the morning (6 am-12 noon) and another in the evening (6 pm-12 midnight) for acute coronary diseases.
  • Cerebrovascular accidents also showed similar morning and afternoon peaks.
Abstract

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