[Epidemiologic chronorisk of acute cardio-cerebrovascular diseases].
This review summarizes the accumulated data demonstrating that several cardio-cerebrovascular diseases do not occur with casual periodicity, but present a predictable critical time of ultradian, circadian, or infradian recurrence in their onset. In fact, during the last years, it has been clearly established that there is a prominent increase in a definite period of the day, of the week, and of the year in the frequency of onset of acute myocardial infarction, sudden cardiac death, stroke, and fatal pulmonary thromboembolism. Morning hours, week-end, and winter seem to be the periods at higher risk, since a number of physiological processes that could contribute to the onset of the disease are intensified. Also environmental and behavioural conditions could contribute to these peaks. Consequently, the periodicity in the occurrence of these diseases may be due to the relationships between the exogenous factor rhythms, the endogenous biological rhythms, and the disease. These epidemiological and chronopathological observations suggest the introduction of time as a measurable structure for the clinical risk, and the term "chronorisk" as a predictable condition of temporally periodic or permanent risk for human health, which is generated by a temporal-quantitative disorder in the physiological course of the biological oscillating functions. The temporal recurrences in the onset of the acute diseases are not only epidemiological data, but, since the reasons for these rhythm changes in pathology are likely multifactorial, the study of such rhythms will probably help in the understanding of the pathogenesis and the triggering mechanisms. Moreover, further investigations of these rhythmicities may help the planning of more effective preventive therapy.
Natali
G
G
Dipartimento di Medicina interna, Università, L'Aquila.
Colantonio
D
D
Casale
R
R
Pasqualetti
P
P
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D002909:Chronobiology Phenomena; D002940:Circadian Rhythm; D003645:Death, Sudden / Q000453:epidemiology; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology; D010507:Periodicity; D011655:Pulmonary Embolism / Q000453:epidemiology; D012307:Risk Factors; D012621:Seasons
Cronorischio epidemiologico della malattie cardiocerebrovascolari acute.