Chronobiological aspects of acute cerebrovascular diseases.
The study was aimed at further investigating the circadian and circannual patterns of stroke onset. Study design and type of participants: 977 strokes (475 in men and 502 in women) concerning 926 subjects (457 men and 469 women) admitted to Ferrara Hospital in two calendar years (1990-1991), were prospectively investigated. The strokes were classified as based on cerebral infarction (CI), transient ischemic attack (TIA) and cerebral hemorrhage (CH: subarachnoid and intracerebral hemorrhage). Two statistical models of analysis were used. The assessment of circadian and circannual periodicity was performed utilizing the single cosinor method. A separate analysis was performed after distribution of events into 6-hour intervals, and chi-square test for fit was applied to the number of observed versus expected cases. The majority of strokes occurred in the morning between 7 a.m. and noon (35% of cases) and the hypothesis of a uniform distribution of the time onset was rejected on the basis of the chi-square for all subtypes of stroke. A circadian rhythm was found for CI and TIA with acrophase at the 11.56 and 12.41 respectively. Also a circannual periodicity was found for CI with a prevalent peak in October. The spectral analysis detected a circadian cycle for CH having a period of 4 h, and a circannual cycle for TIA with a period of 4 months. This study confirms that stroke is a high-chrono-risk disease, with specific circadian and circannual rhythms. This is very important for a better understanding and control of the underlying factors and in terms of prevention.
Gallerani
M
M
Emergency Department, Ferrara, Italy.
Manfredini
R
R
Ricci
L
L
Cocurullo
A
A
Goldoni
C
C
Bigoni
M
M
Fersini
C
C
D000208:Acute Disease; D000368:Aged; D002543:Cerebral Hemorrhage / Q000453:epidemiology; D002544:Cerebral Infarction / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D002542:Intracranial Embolism and Thrombosis / Q000453:epidemiology; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010507:Periodicity; D012621:Seasons