Why the study?
Circadian and diurnal variation in cerebral blood flow directly contributes to diurnal stroke risk, but evidence regarding cerebrovascular compensatory mechanisms and their integration with systemic hemodynamics requires synthesis.
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Design
Review
This review highlights the critical role of circadian and diurnal rhythms in cerebral blood flow regulation and emphasizes the need for further research on cerebrovascular compensatory mechanisms to better understand and mitigate diurnal stroke risk.
Circadian and diurnal variation in cerebral blood flow directly contributes to the diurnal variation in the risk of stroke, either through factors that trigger stroke or due to impaired compensatory mechanisms. Cerebral blood flow results from the integration of systemic hemodynamics, including heart rate, cardiac output, and blood pressure, with cerebrovascular regulatory mechanisms, including cerebrovascular reactivity, autoregulation, and neurovascular coupling. We review the evidence for the circadian and diurnal variation in each of these mechanisms and their integration, from the detailed evidence for mechanisms underlying the nocturnal nadir and morning surge in blood pressure to identifying limited available evidence for circadian and diurnal variation in cerebrovascular compensatory mechanisms. We, thus, identify key systemic hemodynamic factors related to the diurnal variation in the risk of stroke but particularly identify the need for further research focused on cerebrovascular regulatory mechanisms.
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Webb et al. (2024) studied this question.
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