Diurnal Rhythms, the Renin-Angiotensin System and Antihypertensive Therapy

Michael Schachter


Br J Cardiol. 2004;11(4) 

In This Article

Circadian Rhythm of Cardiovascular Events

Regardless of potential mechanisms, there is little doubt that the peak time for cardiovascular events - myocardial infarction, stroke, sudden death, and hypertensive crises - is in the hours between 6 am and noon, although the exact location of the peak varies between studies.[1,2,12,13] It is hard to envisage that this is not related to the changes in heart rate, blood pressure and in the neurohumoral parameters already mentioned. These also promote other potentially harmful changes, for instance in increased coagulation and platelet activation and reduced fibrinolysis. Trying to minimise these 'excess' events must be a valid therapeutic objective.