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[Epidemiologic chronorisk of acute cardio-cerebrovascular diseases]
G Natali1, D Colantonio, R Casale
1Dipartimento di Medicina interna, Università, L'Aquila.
Insights
Cardio-cerebrovascular diseases show predictable onset patterns, not random. Understanding these biological rhythms, termed "chronorisk," can improve disease prevention and treatment strategies.
Area of Science:
- Chronobiology
- Cardiovascular Medicine
- Neurology
Background:
- Cardio-cerebrovascular diseases exhibit non-random onset patterns.
- Accumulated data reveal predictable critical times for disease recurrence.
Purpose of the Study:
- To review evidence on the periodicity of cardio-cerebrovascular disease onset.
- To introduce the concept of "chronorisk" for health risk assessment.
Main Methods:
- Review of epidemiological and chronopathological data.
- Analysis of temporal patterns in disease occurrence (daily, weekly, yearly).
Main Results:
- Significant peaks in onset frequency observed during specific times (e.g., morning, weekends, winter).
- Physiological, environmental, and behavioral factors likely contribute to these peaks.
- Introduction of "chronorisk" as a measurable health risk parameter.
Conclusions:
- Disease periodicity is linked to interactions between biological rhythms and external factors.
- Understanding these temporal patterns is crucial for elucidating pathogenesis.
- Further research into disease rhythmicity can inform preventive therapies.
Abstract:
This review summarizes the accumulated data demonstrating that several cardio-cerebrovascular diseases do not occur with casual periodicity, but present a predictable critical time of ultradian, circadian, or infradian recurrence in their onset. In fact, during the last years, it has been clearly established that there is a prominent increase in a definite period of the day, of the week, and of the year in the frequency of onset of acute myocardial infarction, sudden cardiac death, stroke, and fatal pulmonary thromboembolism. Morning hours, week-end, and winter seem to be the periods at higher risk, since a number of physiological processes that could contribute to the onset of the disease are intensified. Also environmental and behavioural conditions could contribute to these peaks. Consequently, the periodicity in the occurrence of these diseases may be due to the relationships between the exogenous factor rhythms, the endogenous biological rhythms, and the disease. These epidemiological and chronopathological observations suggest the introduction of time as a measurable structure for the clinical risk, and the term "chronorisk" as a predictable condition of temporally periodic or permanent risk for human health, which is generated by a temporal-quantitative disorder in the physiological course of the biological oscillating functions. The temporal recurrences in the onset of the acute diseases are not only epidemiological data, but, since the reasons for these rhythm changes in pathology are likely multifactorial, the study of such rhythms will probably help in the understanding of the pathogenesis and the triggering mechanisms. Moreover, further investigations of these rhythmicities may help the planning of more effective preventive therapy.