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Epidemiological chronorisk of stroke
P Pasqualetti1, G Natali, R Casale
1Department of Internal Medicine, University of L'Aquila, Italy.
Insights
Stroke occurrence shows daily, weekly, and yearly patterns, with peaks in the morning, on weekends, and in winter. These rhythms vary between stroke types but not by sex.
Area of Science:
- Neurology
- Chronobiology
- Epidemiology
Background:
- Stroke is a leading cause of death and disability worldwide.
- Understanding temporal patterns in stroke occurrence may inform prevention and treatment strategies.
- Previous research has suggested potential daily and seasonal variations in stroke incidence.
Purpose of the Study:
- To investigate the circadian, circaseptan, and circannual rhythms in the onset of symptoms for 667 out-of-hospital stroke cases.
- To differentiate temporal patterns between cerebral infarction and cerebral hemorrhage.
- To examine potential sex-based differences in stroke occurrence timing.
Main Methods:
- Retrospective analysis of 667 stroke cases (508 cerebral infarction, 159 cerebral hemorrhage) from 1971-1988.
- Application of the single cosinor method to analyze temporal patterns.
- Statistical comparison of rhythmicity between stroke subtypes and sexes.
Main Results:
- Significant circadian, circaseptan, and circannual rhythms were observed in overall stroke occurrence.
- Peak stroke incidence occurred in morning hours, on weekends, and during winter.
- Cerebral hemorrhages lacked circadian rhythmicity but showed circaseptan and circannual patterns; cerebral infarctions exhibited all three rhythms. No sex differences were found.
Conclusions:
- Stroke occurrence exhibits distinct temporal patterns, with specific variations between cerebral infarction and hemorrhage.
- Understanding these chronobiological patterns is crucial for advancing stroke pathogenesis research and optimizing treatment timing.
- These findings highlight the importance of considering daily, weekly, and seasonal factors in stroke management.
Abstract:
A retrospective study was undertaken on onset of symptoms in 667 cases of stroke. All strokes occurred out of hospital. There were 382 males and 285 females, observed from 1971-1988. The 667 cases of stroke consisted of 508 cases of cerebral infarction and 159 cases of cerebral hemorrhage. The data, analyzed by the single cosinor method, demonstrate a significant circadian, circaseptan, and circannual rhythmicity in the occurrence of stroke. The peaks occur in the morning hours, in the weekend, and in winter. Cerebral hemorrhages do not have a circadian rhythmicity in their occurrence, while they do present circaseptan and circannual rhythmicity. Cerebral infarctions present circadian, circaseptan, and circannual rhythms. No difference was found between males and females. The possible factors involved in temporal distribution of stroke are discussed. These observations could be useful for a better understanding of the pathogenesis and treatment of stroke.