Circadian variation in the incidence of sudden cardiac death in the framingham heart study population
Abstract
To determine if sudden cardiac death shows circadian variation, the time of day of sudden cardiac deaths in the Framingham Heart Study was analyzed. Analysis was based on mortality data collected in a standardized manner for the past 38 years for each death among the 5,209 persons in the original cohort. The necessary assumptions about the cause and timing of unwitnessed deaths were made in a manner likely to diminish the possibility of detecting an increased incidence of sudden cardiac death during the morning. In the Framingham study, analyses using these assumptions reveal a significant circadian variation (p less than 0.01) in occurrence of sudden cardiac death (n = 429), with a peak incidence from 7 to 9 AM and a decreased incidence from 9 AM to 1 PM. Risk of sudden cardiac death was at least 70% higher during the peak period than was the average risk during other times of the day. Further studies are needed to confirm this finding in other populations, to collect data regarding medications and to determine activity immediately before sudden cardiac death. Investigation of physiologic changes occurring during the period of increased incidence of sudden cardiac death may provide increased insight into its causes and suggest possible means of prevention.
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Adverse cardiovascular events peak in the morning, between approximately 6 AM and noon.
“Epidemiological studies show that adverse cardiovascular events peak in the morning (i.e., between 6 AM and noon)”
From The impact of the circadian timing system on cardiovascular and metabolic function (2012) · cites this paper as Willich et al., 1987
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Self-citation
- Authors
- Willich, S. N., Levy, D., Rocco, M. B., Tofler, G. H., Stone, P. H., & Muller, J. E.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Willich, Stefan N.
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 1987-10
- Volume
- 60
- Issue
- 10
- Pages
- 801-806
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2085834180
- Cited by
- 653
- References
- 39
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 5 · 2023: 6 · 2022: 5 · 2021: 8 · 2020: 20 · 2019: 11 · 2018: 15 · 2017: 13 · 2016: 10 · 2015: 17 · 2014: 15 · 2013: 12 · 2012: 19
- FWCI
- 17.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- sudden cardiac death, circadian variation, time of day, Framingham Heart Study, mortality, risk factors
- MeSH terms
- Adult, Circadian Rhythm, Death, Sudden, Humans, Longitudinal Studies, Middle Aged, Myocardial Infarction, Prospective Studies
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