1987
DOI: 10.1016/0002-9149(87)91027-7
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Circadian variation in the incidence of sudden cardiac death in the framingham heart study population

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Cited by 614 publications
(277 citation statements)
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“…As we hypothesized, the endogenous circadian trough in most of the cardiovascular risk biomarkers, as well as the circadian peak in "protective" vagal markers, occurred during the biological night (≈midnight-8:00 AM; ≈300°-50°) for most variables (except for cortisol: 10:30 PM; 270°; Table 1), possibly underlying the nighttime trough in adverse cardiovascular events in epidemiological studies (3)(4)(5)(6)(7)(8)(9)(10).…”
Section: Discussionmentioning
confidence: 92%
See 1 more Smart Citation
“…As we hypothesized, the endogenous circadian trough in most of the cardiovascular risk biomarkers, as well as the circadian peak in "protective" vagal markers, occurred during the biological night (≈midnight-8:00 AM; ≈300°-50°) for most variables (except for cortisol: 10:30 PM; 270°; Table 1), possibly underlying the nighttime trough in adverse cardiovascular events in epidemiological studies (3)(4)(5)(6)(7)(8)(9)(10).…”
Section: Discussionmentioning
confidence: 92%
“…cardiovascular disease C ardiovascular disease is the leading cause of mortality in both men and women in developed countries (1,2). Epidemiological studies show a clear day/night pattern in risk for myocardial infarction (3)(4)(5)(6), stroke (7), angina (5), ventricular arrhythmias (8), and sudden cardiac death (9) with primary peaks in the morning (≈6:00 AM-noon), secondary peaks in the evening (≈6:00-10:00 PM), and lowest vulnerability during the night (≈midnight-6:00 AM) (reviewed in ref. 10).…”
mentioning
confidence: 99%
“…An emergent area of clinical research is focusing on circadian rhythms and cardiovascular disease (14). For example, it is well recognized that the incidence of several adverse cardiovascular events, like sudden cardiac death (18,35) and myocardial infarction (19), peak in the early morning hours. Recently, clinicians have begun to monitor daily rhythms in heart rate and blood pressure as an index for abnormal autonomic function (14).…”
Section: Discussionmentioning
confidence: 99%
“…There is prominent circadian variability in SCD occurrence with a peak incidence during the waking hours in the morning (Willich et al 1987) which corresponds to the abrupt reduction in heart rate variability during the same time period, signifying the surge in sympathetic activity and withdrawal of vagal activity (Bonnemeier et al 2003). Cardiac diseases such as chronic heart failure (Nolan et al 1998) and myocardial infarction (La Rovere et al 1998) are associated with abnormal cardiac autonomic control including high levels of sympathetic activity, impaired parasympathetic control and subnormal arterial baroreflex sensitivity.…”
Section: Autonomic Nervous System and Sudden Cardiac Deathmentioning
confidence: 99%
“…Left cardiac sympathetic denervation has been shown to be effective in treating and reducing arrhythmia burden in patients with refractory ventricular arrhythmias (Schwartz 2014). Epidemiological studies and studies in patients with implantable cardioverter defibrillators have shown that a high proportion of ventricular arrhythmias and SCD occurs in the early hours of the morning suggesting a strong link with the diurnal changes seen in autonomic nerve activity (Willich et al 1987). Clinical measures of vagal tone (heart rate variability and baroreflex sensitivity) are powerful predictors of mortality in heart failure (Nolan et al 1998) and patients with previous myocardial infarction (MI) (La Rovere et al 1998).…”
Section: Introductionmentioning
confidence: 99%