Acute Effects of Exposure to Cold on Blood Pressure, Platelet Function and Sympathetic Nervous Activity in Humans

Kawahara, Jun; Sano, Hiroshi; Fukuzaki, Hisashi; Saito, Komei; Hiroucht, Hisashi

doi:10.1093/ajh/2.9.724

Cited by 120 publications

(52 citation statements)

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“…Other changes noted in the morning, especially with assumption of the upright posture, include increased heart rate, sympathetic tone, renin activity, and plasma concentrations of cortisol, epinephrine, norepinephrine, and angiotensin II. 9,30,32,38,39 Sympathetic activity may further enhance platelet aggregation, 40 and cortisol may increase sensitivity of the coronary arteries to the vasoconstrictor effects of catecholamines. 41,42 Increased blood viscosity and platelet aggregability in the absence of a compensatory increase in circulating tissue-type plasminogen activator activity results in an environment of relative hypercoagulability.…”

Section: Resultsmentioning

confidence: 99%

Circadian Patterns of ST Elevation Myocardial Infarction in the New Millennium

Kanth

Ittaman

Rezkalla

2013

Clinical Medicine & Research

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Objective: Nearly four decades ago, a circadian pattern of acute myocardial infarction (AMI) with a peak in the early morning waking hours was described. The goal of the present study was to determine whether major changes in lifestyle and significant advances in medical therapy have altered this pattern in the intervening years. Design: Retrospective chart review.Setting: Tertiary care hospital in central Wisconsin. Methods:We examined circadian patterns of ST elevation myocardial infarction (STEMI) in 519 patients diagnosed with STEMI over a 5-year period. Time of symptom onset was obtained from patient self-reports in the medical record and was recorded over 24 hours. Results:We observed a circadian pattern of STEMI occurrence with a morning peak at approximately 11:30 AM. This pattern was highly significant in patients who were not using beta-blockers (P <0.0001) and had no history of diabetes (P <0.0001), but was otherwise absent. The circadian pattern appeared to be attenuated in patients of a younger age, female gender, or who used statins or aspirin. Peak STEMI occurrence was earlier in smokers than non-smokers.Conclusions: Despite significant lifestyle changes and medical advances in the nearly four decades since a circadian pattern of AMI occurrence was first described, patients with STEMI had a circadian pattern of symptom onset with a morning peak. Use of beta-blockers and a history of diabetes mellitus abolished this pattern. Other modifying factors, including medications, age, and gender attenuated, but did not abolish, the circadian pattern.

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Section: Resultsmentioning

confidence: 99%

Circadian Patterns of ST Elevation Myocardial Infarction in the New Millennium

Kanth

Ittaman

Rezkalla

2013

Clinical Medicine & Research

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“…1,2 Investigation of pathophysiologic triggers of AMI showing diurnal variation, such as hemodynamic and hematological variables, has enhanced the understanding of mechanisms of the onset and sequence of coronary heart disease (CHD) events. [3][4][5][6] In recent years, the effects of environmental factors, such as temperature, on the onset of CHD were examined and a seasonal periodicity was reported to exist. Several investigators have showed a seasonal variation in the incidence of the onset of CHD and mortality from AMI with a peak in the winter months.…”

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confidence: 99%

Seasonal Difference in Onset of Coronary Heart Disease in Young Japanese Patients A Comparison With Older Patients

Azegami

Hongo

Yazaki

et al. 2005

Circ J

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t is well known that there is a circadian variation in the onset of acute myocardial infarction (AMI), in which a peak incidence occurs in early to late morning and a secondary peak exists in the late evening. 1,2 Investigation of pathophysiologic triggers of AMI showing diurnal variation, such as hemodynamic and hematological variables, has enhanced the understanding of mechanisms of the onset and sequence of coronary heart disease (CHD) events. [3][4][5][6] In recent years, the effects of environmental factors, such as temperature, on the onset of CHD were examined and a seasonal periodicity was reported to exist. Several investigators have showed a seasonal variation in the incidence of the onset of CHD and mortality from AMI with a peak in the winter months. [7][8][9] In contrast, the greatest frequency of its onset was observed during the hottest season of the year. 10 Thus, the results of the previous studies are conflicting and there have been no precise reports on the onset season of CHD in the young population. The purpose of the present study was to investigate whether or not the seasonal difference was present in the onset of CHD in young patients with CHD compared with older patients with CHD living in Nagano Prefecture, a suburban area of Japan. We also examined the association between the onset season of CHD events and disease classification, severity of coronary lesions, and established coronary risk factors in the young patients. Methods SubjectsNagano Prefecture is a suburban community with a population of approximately 2.2 million. The population of people aged ≥65 years accounts for approximately 25% of the whole population. Twenty of the 117 general medical hospitals that hold over 100 beds were selected and asked to be collaborative institutions. These 20 hospitals covered the entire region of Nagano Prefecture.Eligible young subjects aged ≤40 years were admitted to one of these 20 hospitals and diagnosed with CHD between 1992 and 2002, and 101 young patients were enrolled. According to the statistics of National Cardiovascular Center of Japan between 1977 and 1996, AMI events reached a peak in men aged in their 60 s and in women aged in their 70 s, and the population from 50 to 79 years occupied over 80% of the AMI patients. 11 Therefore, eligible older subjects were set patients aged ≥50 years who were diagnosed with CHD from 1992 to 2002, and 94 older patients consented to participate in the study.After written informed consent was obtained from each subject, biological data, including the number of coronary lesions and the particular month of the onset of CHD events, was copied from medical records. The presence of metabolic disorders, including obesity, hypertension, dyslipidemia, and diabetes, was noted. Then, each participant was asked to complete a mailed questionnaire addressing lifestyle factors, such as cigarette smoking, physical activi- Background The aim of the present multicenter study was to investigate whether there is a seasonal difference in the onset of coronary heart dis...

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“…5 Colder weather has been shown to alter hemodynamic (blood pressure [BP], sympathetic tone) and hematological (platelet count, fibrinogen) factors favoring arterial thrombosis. 3,6,7 Thus, independent studies seem to conclude that the seasonal variation in plasma fibrinogen is related in time with the reported seasonal variation in coronary events. 5 Fibrinogen is also characterized by a highly significant circadian variation, correlated in time with that of BP.…”

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confidence: 99%

Seasonal Variation of Fibrinogen in Dipper and Nondipper Hypertensive Patients

et al. 2003

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Background-A seasonal variation with higher values in winter has been previously reported in plasma fibrinogen, a recognized marker of the potential risk of myocardial infarction and stroke. The lack of nocturnal decline in blood pressure has also been associated with an increase in cardiovascular events. Accordingly, we have compared the yearly variation of plasma fibrinogen in dipper and nondipper hypertensive patients. Methods and Results-We studied 1006 stage 1 to 2 hypertensive patients (482 men and 524 women, 53.0Ϯ13.4 years of age). Blood pressure was measured every 20 minutes during the day and every 30 minutes at night for 48 consecutive hours. Physical activity was simultaneously evaluated at 1-minute intervals with a wrist actigraph. A blood sample was collected on the same day before starting blood pressure monitoring. The circannual variation of fibrinogen was established for all patients as well as for subgroups of dippers and nondippers (nϭ513; nocturnal blood pressure decline Ͻ10%) by multiple-component analysis. For the whole group of patients, fibrinogen was characterized by a highly significant seasonal variation (PϽ0.001) with a mean value of 318 mg/dL, double circannual amplitude (extent of predictable change along the year) of 40 mg/dL, and time of peak value in February. Throughout the year, the nondippers showed higher plasma fibrinogen levels than did the dippers (PϽ0.001). Conclusions-The elevated plasma fibrinogen levels in nondipper patients appear to be directly related to their increased risk in vascular events, which are more prominent during the late winter months.

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Acute Effects of Exposure to Cold on Blood Pressure, Platelet Function and Sympathetic Nervous Activity in Humans

Cited by 120 publications

References 0 publications

Circadian Patterns of ST Elevation Myocardial Infarction in the New Millennium

Circadian Patterns of ST Elevation Myocardial Infarction in the New Millennium

Seasonal Difference in Onset of Coronary Heart Disease in Young Japanese Patients A Comparison With Older Patients

Seasonal Variation of Fibrinogen in Dipper and Nondipper Hypertensive Patients

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