What Did The Research Involve
Researchers looked at the data on 811 patients who were admitted to hospital between 2003 and 2009 with a STEMI, as defined in current clinical practice guidelines. They obtained information on the time of onset of symptoms from patients medical histories, the site of the STEMI and the levels of creatine kinase and troponin I , measured on admission and then every four hours. These two enzymes are chemical markers for damage to the heart tissue and higher levels of enzymes indicate greater damage.
The researchers divided the 24-hour clock into four equal periods, in phase with circadian rhythms. These were midnight to 6am, 6am to noon , noon to 6pm and 6pm to midnight. The time of day that patients had a heart attack was categorised into one of these four periods. Standard statistical methods were used to assess whether there was a relationship between peak enzyme levels in the blood and the time heart attacks occurred. The results were also adjusted for other factors that could affect the size of someones heart attack, such as the presence of diabetes, history of hypertension and the time of year it happened.
Morning Heart Attacks May Follow Body’s Clock
Circadian Rhythms Influence the Heart, Study Shows
Dec. 20, 2004 — Ten o’clock in the morning is the most dangerous hour of the day for your heart, with more heart attacks and strokes occurring then than at any other time. The body’s internal clock may be partly responsible, new research shows.
Heart attacks and strokes peak around 10 a.m. “These events do not occur randomly during the day,” say experts, including Kun Hu of Boston University.
What explains the pattern? For many people, mornings hum with activity from the time their feet hit the floor to the start of work, school, or other commitments. Throw in a morning workout, job angst, or a rough commute, and you’ve got plenty of factors that could conceivably tax the heart, which might already be strained by poor diet and conditioning.
Or could something else also be at work? Hu’s team looked past the mad pace of mornings to a more subtle influence: circadian rhythms. They are the body’s natural pacemaker, which is governed by sleep-wake or light-dark cycles. This pacemaker controls functions such as sleep.
Hu and colleagues wanted to see if circadian rhythms affect the heart. They recruited five healthy young people about 25 years old.
Using electrocardiographs, the researchers monitored participants’ heartbeats for two days. Then, they sent subjects into a kind of temporary twilight zone.
That’s a “well-known window of cardiac vulnerability,” say the researchers.
Why Heart Attacks Happen In The Morning
Ever wondered why founding President Mzee Jomo Kenyatta died at 3.30am, and former President Daniel Arap Moi went to be with the Lord at 5.20am? Sarah Obama, former USA President Barack Obamas grandma, died at 4am while undergoing treatment at Jaramogi Oginga Odinga Referral Hospital in Kisumu.
Nyeri Governor Nderitu Gachagua died at 2.15am from Pancreatic cancer on January 6, 2019, while Migori senator Ben Oluoch died from throat cancer shortly after midnight on June 19, 2018. Billionaire Naushad Merali businessman and chairman of Sameer group, slipped away on July 3, 2021 at 5am, as did His Eminence, Maurice Michael Cardinal Otunga, the revered elder and the first Kenyan Cardinal of the Catholic Church, who died at 6:45am of cardiac arrest on September 6, 2003.
Well, turns out it is not just a coincidence. Research has shown that most heart attacks happen in the morning, and within the first few hours of waking up.
Not only that, various research has shown that many people are more likely to have a heart attack on a Monday morning. This applies for sudden cardiac death from life-threatening heart rhythm problems, and death from other heart diseases.
While no specific reason has been identified behind this phenomenon, it is said to be triggered by many causes, including a high level of stress hormones, blood being thinner in the morning, and an increase in blood pressure levels during morning hours.
Morning Heart Attacks Vs Overnight Heart Attacks
The patients included in the study all had a type of heart attack caused by blockages in the arteries.
Heart muscle damage was calculated by examining peak concentrations of creatine kinase and troponin-I , key enzymes released in response to muscle injury.
Heart attack timing was divided into four six-hour time periods over 24 hours.
As expected, the largest number of heart attacks occurred in the morning hours, with 269 patients needing treatment between 6 a.m. and noon. The fewest heart attacks occurred between midnight and 6 a.m., with 141 patients needing treatment.
Patients whose heart attacks occurred between 6 a.m. and noon had 21% higher CK and TnI levels than patients whose heart attacks occurred between midnight and 6 a.m.
Ibanez says the recognition that morning heart attacks may be more severe could have important implications for their treatment.
Early treatment with clot-busting drugs and angioplasty can prevent or limit damage to the heart muscle, but most cardiac catheterization labs are not fully staffed in the early morning hours.
Research suggests that around-the-clock access to a catheterization lab reduces treatment delays, he says.
âIt could be that having one or two cath labs open in a city could have a significant impact on outcomes,â Ibanez says.
Not So Sweet: Artificial Sweeteners Linked To Heart Disease
Artificial sweeteners Aspartame, Sucralose, and Ace K may be culprits behind some heart disease, and researchers are reportedly warning they shouldn’t be thought a healthy sugar substitute. Also: Forehead thermometers, the new Apple Watch with women’s health features, and more.
NPR:Forehead Thermometers Could Be Less Likely To Detect Fevers In Black PatientsThe chances of a forehead thermometer detecting fevers in Black patients were 26% lower than oral thermometers. Though the differences were small, the researchers noted that fevers could slip under the radar if the number is below commonly used thresholds.
ABC News:New Apple Watch Feature Designed To Help Women Track Fertility: What To KnowThe newest model of the Apple Watch will offer women features to track their menstrual cycles and when they may be the most fertile, Apple announced Wednesday at a launch event at the company’s California headquarters. Among the Apple Watch Series 8’s advanced features is a temperature sensor that offers an estimate for the last time a woman wearing the watch has ovulated.
Stat:Juul Settlement Wont Overhaul The E-Cig Landscape, Experts WarnOn Tuesday, a group of more than 30 attorneys general announced they had reached a landmark $438.5 million settlement with the e-cigarette maker Juul over its alleged marketing toward children. But the settlement doesnt have nearly the scope or the import of earlier efforts to rein in tobacco companies marketing, experts told STAT.
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Sitting Posture In Toilet
The cardiac events that occur during defecation are, in many cases, the result of using the sitting posture for waste elimination. Intensive and repeated Valsalva Manoeuvres are needed for emptying the bowels in a sitting position. In fact, VM was found to be a triggering event.
We, humans, are optimally designed to poop in the squatting position. However, with globalization came the toilets that required people to sit comfortably rather than squat.
For many years, experts have started pointing out the western toilet positions harms on our digestive system. Using a sitting toilet triggers the risk more than a squatting toilet as it requires more strain.
Various studies have pointed out how western toilets cause constipation, hemorrhoids, Inflammatory Bowel Disease , appendicitis, and even heart attacks or cardiovascular events like cardiac arrest .
Explaining Why So Many Cases Of Cardiac Arrest Strike In The Morning
Note to journalists: Please report that this research was presented at a meeting of the American Chemical Society.
A press conference on this topic will be held Sunday, Sept. 8, at 8 a.m. in the ACS Press Center, Room 211, in the Indiana Convention Center. Reporters can attend in person or access live audio and video of the event and ask questions at www.ustream.tv/channel/acslive.
INDIANAPOLIS, Sept. 8, 2013 Evidence from people with heart disease strongly supports the existence of the molecular link first discovered in laboratory mice between the bodys natural circadian rhythms and cardiac arrest or sudden cardiac death the No. 1 cause of death in heart attacks, a scientist said here today.
The research, which offers the most focused explanation ever for SCDs predilection for the morning hours, was part of the 246th National Meeting & Exposition of the American Chemical Society , the worlds largest scientific society. The meeting, which features almost 7,000 reports on discoveries in science and other topics, continues through Thursday in the Indiana Convention Center and downtown hotels.
One of the deepest mysteries about SCD has been its timing. Health experts have known for more than 30 years that the erratic heartbeat responsible for SCD strikes most often at certain times of the day. The peak risk hours range from 6 a.m. to 10 a.m., with a smaller peak in the late afternoon.
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The Truth About Morning Heart Attacks
Is your heart really more likely to conk out in the morning?
A new study seems to support a cautionary old wives’ tale: Your heart is most vulnerable in the a.m. And sure, the time before work is hectic, but is your ticker really more vulnerable in the morning light?
Yes: Your body’s circadian rhythm may actually contribute to your risk of having a heart attack, researchers at the Brigham and Women’s Hospital and Oregon Health & Science University report. In the early hours of the morning, your levels of PAI-1a protein that prevents your body from breaking down blood clots, a major contributor to heart attack and strokespike. And PAI-1 isn’t the only thing at work, says Eric Topol, M.D., director of the Scripps Translational Science Institute. Your body also sees a natural surge in cortisol and adrenaline, taxing your heart.
And people with long commutes who are up before 6 a.m. may be hit by a double whammy. Your bodys surge in PAI-1 and cortisolbeginning around 3 a.m. and lasting into the early morningmay coincide with the stress of making it to work on time if youre up in those hours.
More From Men’s Health
Besides painting a clearer picture of cardiovascular diseasethe No. 1 killer of men and womenthese discoveries may eventually lead to new drugs targeting PAI-1 and other proteins, researchers report.
The Wrong Sequence Of Bath
While bathing or showering, do not wet the head and hair first. This is the wrong sequence. writes a professor at UiTM National Sports Board.
Sequenced bathing is essential to avoid such incidences. Start with wetting your legs and up to your head gently. Know further about sequenced bathing in detail.
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What Kind Of Research Was This
The aim of this study was to investigate whether the time of day affected the severity of damage caused by a type of heart attack called ST segment elevation myocardial infarction . This was a retrospectivecross-sectional analysis of 811 STEMI patients admitted to hospital between 2003 and 2009. This type of heart attack is caused by a prolonged blockage of blood supply to the coronary artery and usually causes large areas of damage to the heart muscle.
The researchers point out that the circadian clock is known to influence a number of cardiovascular factors, including blood pressure and heart rate, and that heart attacks peak in incidence during the early morning hours. As yet, little research has been carried out in patients to look at whether the degree of damage caused by a heart attack is affected by the time of day it occurs.
Heart Attacks More Common In The Morning
Heart attacks are five to six times more likely to occur in the early morning hours between 1 and 5 a.m., and studies have shown that morning heart attacks tend to be more severe than those that happen later in the day.
Though it has often been assumed that this is partly due to the stress associated with going to work in the morning, a new study finds a more biological basis for the peak.
The study, published in the journal Nature, has identified a link between your circadian rhythm and the rise in early morning heart attacks.
Experts have known that the type of heart attack that tends to occur in the morning is called ventricular fibrillation, caused by a rapid irregular heart beat . The study, performed on mice, discovered events on the molecular level that can lead to these more rapid irregular heartbeats.
Levels of a protein called KLF15 vary throughout the day, following the lead of the circadian clock, which governs hormonal rhythms in your body. The study found that having too low or too high levels of KLF15 set off a cascade of events that change the potassium current, affecting the electrical recovery time of heart muscle cells.
The research needs to be repeated in humans to see if KLF15 is as important. If it is, it could lead to medications that target arrhythmias.
Our work suggests that drugs that would fine tune electrical activity of the heart could perhaps prevent sudden cardiac death in the morning, but this remains to be studied, says Wehrens.
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Heart Attacks In The Morning Are More Severe
Study Shows Heart Attacks in the Morning Are More Serious Than Those in Overnight Hours
Researchers reviewed data from more than 800 heart attack patients treated at a hospital cardiac center in Madrid, Spain, between 2003 and 2009. Heart attacks that occurred in the morning hours were associated with about 20% more dead heart tissue.
The study is the first to link circadian fluctuations to heart attack severity in humans. If confirmed, the findings could affect treatment and research, study researcher Borja Ibanez, MD, PhD, tells WebMD.
Ibanez is a senior investigator for Spainâs National Center for Cardiovascular Research and an interventional cardiologist at Madridâs Hospital Clinico San Carlos.
The association was quite robust,â he says. âIn our study, events that took place in the morning were associated with more damage.â
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Which Season Has The Most Heart Attacks
Several studies have demonstrated that there is seasonal variation in heart attacks.
They are most likely to occur in the winter, and least likely to occur in the summer. This is not just true for heart attacks, but also other cardiovascular events. Several explanations have been proposed. Winter is associated with infections and derangements in cholesterol levels. The lower temperatures cause increased stress on the walls of the heart and reduced flow to the arteries that supply the heart. Winter is also associated with psychological stress, depression and decreased activity. In fact, researchers have shown people are most likely to die from heart disease over the Christmas and New Years period.
Heart Attacks ‘worse In The Morning’
Heart attacks are far more dangerous in the mornings than at any other time of the day, reported the Daily Mail . It said that patients who had an attack between 6am and midday suffered a fifth more damage to their heart muscle compared with those who had a heart attack later on.
The story comes from a study of more than 800 heart attack patients, examining the possible association between the time of day that heart attacks happen and the levels of two enzymes in the blood. These enzymes are markers of damage to the heart tissue, and higher levels indicate larger areas of damage.
Patients who had a heart attack between 6am and noon were found to have higher blood levels of these enzymes than those who had heart attacks later in the day, with increases in peak levels of 18.3% and 24.6%. The researchers suggest that these patients had significantly larger heart attacks than those whose heart attacks occurred at other times of the day.
The study was well-conducted and its findings add to what is known about circadian rhythms and heart risk. The study has several factors that limit its interpretation, however, including the use of a surrogate marker for damage to the heart , rather than looking at heart damage directly. There may also have been other factors affecting how much damage took place, for example, how quickly people received treatment due to the time of day of their attack.
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Stress Is Likely A Major Factor
Dr. Chugh and his team studied data available from the Oregon Sudden Unexpected Death Study, which began in 2002.
For the analysis, the investigators looked at the data collected from emergency medical reports in 20042014. During this time, 1,535 adults had sudden cardiac arrests and died as a result.
Of these people, note the authors, only 13.9 percent died between 12 a.m. and 6 a.m. Contrary to older research and an ensuing widespread belief, the study found no evidence of a higher prevalence of sudden cardiac arrests on Mondays.
While there are likely several reasons to explain why more cardiac arrests happen outside of previously identified peak times, stress is likely a major factor, explains Dr. Chugh.
Because sudden cardiac arrest is usually fatal, we have to prevent it before it strikes, he adds.
We now live in a fast-paced, always on era that causes increased psychosocial stress and possibly, an increase in the likelihood of sudden cardiac arrest.
Dr. Sumeet Chugh
Dr. Chugh also shares some directions for future research, explaining, Our next steps are to conclusively determine the underlying reasons behind this shift, then identify public health implications as a result.