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Circadian rhythm in acute stroke
F K Pardiwalla1, M E Yeolekar, S K Bakshi
1Seth G. S. Medical college, Parel, Bombay.
Insights
Stroke events, including ischemic and hemorrhagic types, show a peak occurrence in the late morning and early afternoon. This circadian rhythm in stroke onset, observed in the Indian population, highlights potential windows for targeted medical intervention.
Area of Science:
- Neurology
- Circadian Biology
- Epidemiology
Background:
- Ischemic events, such as myocardial infarction, exhibit a circadian pattern.
- Previous studies on the circadian variation of stroke onset have yielded conflicting results.
- Blood pressure also shows significant daily fluctuations.
Purpose of the Study:
- To investigate the circadian variation of stroke onset in the Indian population.
- To determine if stroke onset, including both infarct and hemorrhage, follows a predictable daily pattern.
- To assess if hypertension influences the timing of stroke occurrence.
Main Methods:
- A study of 182 consecutive acute stroke patients admitted within 12 hours of symptom onset.
- Analysis of stroke onset times to identify circadian patterns.
- Inclusion of patients with both ischemic and hemorrhagic strokes, as well as those with hypertension.
Main Results:
- The highest frequency of stroke onset occurred between 6:01 a.m. and 2:00 p.m.
- This circadian pattern was observed in both ischemic (infarct) and hemorrhagic stroke patients.
- Patients with hypertension also demonstrated a similar peak in stroke onset during these hours.
Conclusions:
- Stroke onset exhibits a significant circadian variation in the Indian population, peaking in the late morning/early afternoon.
- Understanding these high-risk periods may allow for optimized timing of medication and interventions.
- Further research could explore chronotherapy strategies for stroke prevention and management.
Abstract:
Ischemic events have been reported to follow a circadian rhythm. The frequency of myocardial infarction is found to be increased between 6:01 a.m. and 2:00 p.m. Blood pressure also demonstrates a similar circadian variation. Circadian variation of stroke onset has also been reported, but with contradictory findings. To determine this in the Indian population, we studied 182 consecutive patients of acute stroke admitted to our words within twelve hours of onset. The frequency of onset of stroke was found to be highest between 6:01 am and 2:00 pm, in patients of infarct as well as haemorrhage. Patients of hypertension also showed a similar variation. Thus, the identification of periods of high risk, may help by matching drug doses with periods of vulnerability.