Circadian rhythmicity of stroke onset. Intracerebral and subarachnoid hemorrhage.

Sloan, Michael A.; Price, Thomas R.; Foulkes, Mary A.; Marler, John R.; Mohr, J. P.; Hier, Daniel B.; Wolf, P A; Lr, Caplan

doi:10.1161/01.str.23.10.1420

Cited by 89 publications

(82 citation statements)

References 35 publications

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“…2,4,6,11,12,14,15,17,18,20,22,24,26,27,[29][30][31][32][33] Hospital-based and populationbased studies that demonstrated significant seasonal variation found that the peak period for SAH differed widely. [4][5][6]15,20,24,26,32,33) No statistically significant seasonal variations were also observed in some studies.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6]15,20,24,26,32,33) No statistically significant seasonal variations were also observed in some studies. 2,12,14,17,22,27,[29][30][31] The highest occurrences of SAH were found in spring in women and in late fall in men, 4) in spring and fall in men, and in winter in women, 24) and in winter in women and no peak in men. 32) Our data resembled the results of 10 years of the Canadian Collaborative Study Group although the lowest occurrence in their male group was in summer whereas that of in the present study was in winter.…”

Section: Discussionmentioning

confidence: 99%

“…8,13) However, investigation of the seasonal incidence of SAH has identified environmental and sociomedical factors correlated with aneurysm rupture. 2,4,6,11,12,14,15,17,18,20,22,24,26,27,[29][30][31][32][33] The present study investigated the relationship between sex and seasonal occurrence of SAH.…”

Section: Introductionmentioning

confidence: 99%

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Involvement of Meteorological Factors and Sex in the Occurrence of Subarachnoid Hemorrhage in Japan

Umemura

Hirashima

Kurimoto

et al. 2008

Neurol. Med. Chir.(Tokyo)

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The sex difference in the seasonal occurrence of subarachnoid hemorrhage (SAH) and the association of meteorological factors in Japan were analyzed in 1006 consecutive patients with SAH in Toyama, Japan from 1996 to 2000. The study investigated whether these meteorological factors could explain the seasonality of the incidence of SAH in each sex. Seasonal variation of SAH occurrence peaked in spring in men, but peaked in spring and winter in women. The difference between maximum temperature and minimum temperature was the greatest on the day previous to SAH occurrence in multiple individuals in men, whereas mean humidity was the greatest on that day in women. Interestingly, the difference between maximum temperature and minimum temperature peaked in spring and mean humidity in winter from the meteorological data over the 5 years. The relationship between humidity and occurrence of SAH may explain the sex difference of the incidence of aneurysmal SAH. The humidity change may be a specific and additional meteorological factor for the incidence of SAH in women.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Involvement of Meteorological Factors and Sex in the Occurrence of Subarachnoid Hemorrhage in Japan

Umemura

Hirashima

Kurimoto

et al. 2008

Neurol. Med. Chir.(Tokyo)

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“…The maintenance of blood pressure reduction during the first hours of the morning, after the patient wakes up, is another major point to be considered, because the most likely peak time for cardiovascular events occurs between 06:00-11:00 [2][3][4][5] . The goals for blood pressure levels have become increasingly rigorous.…”

Section: A Multicenter Open-label Study Of the Efficacy And Safety Omentioning

confidence: 99%

A multicenter, open-label study of the efficacy and safety of telmisartan in mild to moderate hypertensive patients

Plavnik¹,

Ribeiro²

2002

Arq. Bras. Cardiol.

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Objective -The ideal antihypertensive agent must have the following profile: it must promote effective blood pressure (BP) reduction, maintain blood pressure control over 24 hours with a single daily dose, be as effective as possible for a great number of hypertensive patients, cause no undesirable side effects have no negative effects on metabolic parameters 1 , and finally be reasonably affordable. None of the antihypertensive agents currently available have all of these characteristics. More recently, some new drugs have demonstrated some of the desired characteristics of an ideal drug.The maintenance of blood pressure reduction during the first hours of the morning, after the patient wakes up, is another major point to be considered, because the most likely peak time for cardiovascular events occurs between 06:00-11:00 2-5 . The goals for blood pressure levels have become increasingly rigorous. The new goals are based on the results from the most recent prospective clinical studies, such as HOT 6 and UKPDS 7 , which demonstrate that more rigorous blood pressure control provides greater protection against cardiovascular morbidity and mortality in hypertensive populations. These findings emphasize that antihypertensive agents must keep blood pressure under control for the longest period of time possible.The renin-angiotensin system (RAS) plays an important role in the pathogenesis and maintenance of the mechanisms involved in the development of essential hypertension. Some of its actions have been well characterized 8 . Briefly, angiotensin II (AII) acts by binding to its specific subtype AT 1 receptor, leading to vasoconstriction, increasing peripheral resistance (raising blood pressure levels), and promoting some trophic actions (wall and heart vessels hypertrophy).A new class of antihypertensive agents, the angiotensin II (AII) antagonist receptors (AIIAR) (ie, losartan, valsartan, irbesartan, candesartan, and telmisartan), blocks the binding of AII to its subclass receptor AT 1 . This action prevents the potent vasoconstriction generated by AII.

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“…2,4,7,13,15) However, other studies have not found significant seasonal variation or meteorological association. 1,10,14,[22][23][24] Interpretation of such results is complicated by the multiple factors associated with the design of each study, including the number of patients studied, criteria for patient selection (based on onset, admission, surgical treatment, or death), method of sampling (community-based or hospital-based), and the statistical method used for the analysis. In addition, the complexity of the physical factors which may influence the process of aneurysmal rupture could also cause the conflicting results.…”

Section: Introductionmentioning

confidence: 99%

Differential Effects of Activity and Climate on Onset of Subarachnoid Hemorrhage.

Kawai

Nonaka

Suzuki

et al. 2001

Neurol. Med. Chir.(Tokyo)

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Conflicting findings of the effect of climate on onset of subarachnoid hemorrhage (SAH) may result from the influence of strenuous activities which can trigger aneurysmal rupture independent of climatological factors. The effect of climate and patient activities on onset of SAH were analyzed. The clinical records of 786 consecutive patients with aneurysmal SAH admitted to our hospital for 10 years were reviewed. Activities at onset were categorized according to the intensity of strain at onset. Seasonal variation, circannual cyclic trend, and association with 90 meteorological factors were examined in each category and the results were compared between categories. Bimonthly occurrence in the light strain group showed a significant seasonal variation and cyclic trend with two peaks in early spring and fall, whereas no significant trend was detected in the overall patients and in the heavy strain group. The significant meteorological factors were global solar radiation, sunshine hours, changes in mean and minimum temperature and mean vapor pressure from the previous day, and minimum pressure in the previous 7 days. Lower global solar radiation in the light strain group was associated with onset with the lowest p value (p ＝ 0.0046). No factors were significant in the heavy strain group. There is some evidence of the possible influence of climatological factors on onset of SAH without strenuous activity. Strenuous activity seems to affect onset more strongly, which masks any effect of climate.

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Circadian rhythmicity of stroke onset. Intracerebral and subarachnoid hemorrhage.

Cited by 89 publications

References 35 publications

Involvement of Meteorological Factors and Sex in the Occurrence of Subarachnoid Hemorrhage in Japan

Involvement of Meteorological Factors and Sex in the Occurrence of Subarachnoid Hemorrhage in Japan

A multicenter, open-label study of the efficacy and safety of telmisartan in mild to moderate hypertensive patients

Differential Effects of Activity and Climate on Onset of Subarachnoid Hemorrhage.

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