Cross-sectional and longitudinal associations between circadian alignment and stroke in US adults

Circadian rhythm disorders can cause metabolic disturbances and increase susceptibility to stroke. This study utilized circadian rhythm data from individuals aged 20 years and older in the NHANES (2011-2014) database. Cross-sectional and longitudinal analyses employed phase analysis (including the assessment of phase magnitude and phase acrophase) to explore associations between the light-dark cycle and the activity-rest cycle within circadian rhythms. The average follow-up duration was 83 months. Participants with the lowest phase magnitude (i.e., the least overlap between the light cycle and activity cycle) exhibited significantly increased risks of stroke, all-cause mortality, and cardiovascular mortality. Among those with low phase magnitude, women and older adults were more prone to stroke than men and younger adults, while men and older adults were more susceptible to cardiovascular mortality and all-cause mortality. These findings underscore the importance of quantitatively assessing circadian disruption and suggest that targeted interventions aimed at improving circadian alignment may play a role in mitigating stroke-related risk.