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Circadian variation in cardiovascular emergencies among the elderly
Chihiro Kawakami1, Kenji Ohshige, Osamu Tochikubo
1Department of Public Health, Yokohama City University, Graduate School of Medicine, Kanagawa, Japan. t046019b@yokohama-cu.ac.jp
Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|January 25, 2008
Summary
Elderly individuals experience a significant increase in emergency medical events like cardiovascular disease and cardiopulmonary arrest (CPA) during the morning hours. This pattern, also seen in heat stroke cases, highlights potential daily risk factors for this demographic.
Area of Science:
- Emergency Medicine
- Gerontology
- Public Health
Background:
- Emergency medical service utilization is rising among the elderly.
- Understanding temporal patterns of disease can help identify risk factors and improve preventative strategies.
Purpose of the Study:
- To characterize the circadian variation in emergency calls for elderly patients.
- To analyze the daily patterns of cardiovascular disease, cardiopulmonary arrest (CPA), and heat stroke in the elderly population.
Main Methods:
- Analysis of ambulance transport records from 1997-2003 (874,495 patients).
- Utilized a partial Fourier model to identify circadian patterns and peak occurrence times for various emergency events.
- Stratified analysis by age group (elderly vs. younger patients).
Main Results:
- Elderly patients showed a prominent morning peak for cardiovascular disease and CPA.
- Younger patients exhibited similar morning and evening peaks for these conditions.
- Heat stroke events in the elderly peaked around noon, occurring frequently between 10 AM and 3 PM.
Conclusions:
- The elderly experience a distinct morning peak for cardiovascular disease, CPA, and heat stroke.
- Potential contributing factors include natural blood pressure fluctuations and overnight dehydration leading to hemoconcentration.
- Circadian rhythm analysis is crucial for understanding and mitigating emergency event risk in the elderly.
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