Key result
Cardiovascular events such as myocardial infarction, sudden cardiac death, and stroke occur more frequently in the morning, driven by diurnal variations in biologic functions and blood pressure.
Understanding the morning peak in cardiovascular events and its relationship to circadian rhythms like blood pressure may help optimize the timing of pharmacologic treatments.
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Morning CV event peak supports chronotherapy exploration; leaves open whether timed dosing improves outcomes.
Convincing evidence has recently accumulated that several unfavorable cardiovascular events show a well defined pattern in their occurrence throughout the day. Myocardial angina and infarction, sudden cardiac death, arrhythmias, fatal pulmonary thromboembolism, and ischemic and hemorrhagic cerebrovascular accidents occur more frequently in the morning, after awaking, until noon. Diurnal variations in multiple biologic functions, such as assumption of an upright posture associated with increased platelet aggregability, changes in blood clotting, fibrinolysis, and vascular tone and resistance, may be potentially active triggering factors. Moreover, variations in sympathetic tone, catecholamine secretion, and blood pressure have to be considered. The role of triggering factors and their relationships with blood pressure patterns is discussed in view of an optimized pharmacologic treatment.
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Manfredini et al. (1996) conducted a review in Cardiovascular events. Circadian rhythms and blood pressure patterns was evaluated. Cardiovascular events such as myocardial infarction, sudden cardiac death, and stroke occur more frequently in the morning, driven by diurnal variations in biologic functions and blood pressure.
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