Exploring the periodicity of cardiovascular events in Switzerland: Variation in deaths and hospitalizations across seasons, day of the week and hour of the day

Reavey, Michelle; Saner, Hugo; Paccaud, Fred; Marques-Vidal, Pedro (2013). Exploring the periodicity of cardiovascular events in Switzerland: Variation in deaths and hospitalizations across seasons, day of the week and hour of the day. International journal of cardiology, 168(3), pp. 2195-2200. Elsevier 10.1016/j.ijcard.2013.01.224

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Purpose

The purpose of this study is to explore the periodical patterns of events and deaths related to cardiovascular disease (CVD), acute myocardial infarction (AMI) and stroke in Swiss adults (≥18years).

Methods

Mortality data for period 1969–2007 (N=869,863 CVD events) and hospitalization data for period 1997–2008 (N=959,990 CVD events) were used. The annual, weekly and circadian distribution of CVD-related deaths and events were assessed. Multivariate analysis was conducted using multinomial logistic regression adjusting for age, gender and calendar year and considering deaths from respiratory diseases, accidents or other causes as competitive events.

Results

CVD deaths and hospitalizations occurred less frequently in the summer months. Similar patterns were found for AMI and stroke. No significant weekly variation for CVD deaths was found. Stratification by age and gender showed subjects aged <65years to present a higher probability of dying on Mondays and Saturday, only for men. This finding was confirmed after multivariate adjustment. Finally, a circadian variation in CVD mortality was observed, with a first peak in the morning (8–12am) and a smaller second peak in the late afternoon (2–6pm). This pattern persisted after multivariate adjustment and was more pronounced for AMI than for stroke.

Conclusion

There is a periodicity of hospitalizations and deaths related to CVD, AMI and stroke in Switzerland. This pattern changes slightly according to the age and sex of the subjects. Although the underlying mechanisms are not fully identified, preventive measures should take into account these aspects to develop better strategies of prevention and management of CVD.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
UniBE Contributor:	Saner, Hugo Ernst
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0167-5273
Publisher:	Elsevier
Language:	English
Submitter:	Prisca Eser
Date Deposited:	02 May 2014 10:34
Last Modified:	02 Mar 2023 23:24
Publisher DOI:	10.1016/j.ijcard.2013.01.224
Uncontrolled Keywords:	Seasonality, CVD, AMI, Stroke, Hourly variation, Daily
URI:	https://boris.unibe.ch/id/eprint/42398