Circulation, Vol 75, 131-138, Copyright © 1987 by American Heart Association
JE Muller, PL Ludmer, SN Willich, GH Tofler, G Aylmer, I Klangos and PH Stone
To determine whether sudden cardiac death exhibits a circadian rhythm
similar to that recently demonstrated for nonfatal myocardial infarction,
we analyzed the time of day of sudden cardiac death as indicated by death
certificates of 2203 individuals dying out of the hospital in Massachusetts
in 1983. The data reveal a prominent circadian variation of sudden cardiac
death, with a low incidence during the night and an increased incidence
from 7 to 11 A.M. The pattern is remarkably similar to that reported for
nonfatal myocardial infarction and episodes of myocardial ischemia. The
finding that the frequency of sudden cardiac death is increased in the
morning is compatible with hypotheses that sudden cardiac death results
from ischemia or from a primary arrhythmic event. Further study of the
physiologic changes occurring in the morning may provide new information
supporting or refuting these hypotheses, thereby leading to increased
understanding and possible prevention of sudden cardiac death.
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Circadian variation in the frequency of sudden cardiac death
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T. D. Giles, M. Weber, D. W. Bartels, H. M. Silberman, L. P. Gilderman, and J. F. Burns Treatment of Isolated Systolic Hypertension With Labetalol in the Elderly Arch Intern Med, May 1, 1990; 150(5): 974 - 976. [Abstract] [PDF]
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M. A. Sirgo, R. J. Mills, and V. DeQuattro Effects of Antihypertensive Agents on Circadian Blood Pressure and Heart Rate Patterns: Review Arch Intern Med, December 1, 1988; 148(12): 2547 - 2552. [Abstract] [PDF]
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E. G. Nabel, M. B. Rocco, J. Barry, S. Campbell, and A. P. Selwyn Asymptomatic Ischemia in Patients With Coronary Artery Disease JAMA, April 10, 1987; 257(14): 1923 - 1928. [Abstract] [PDF]
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