Cardiac arrests have become increasingly common and can strike anyone at any time. However, experts say that the majority of people experience it during the early hours of the day. Why it is so? To understand the same, we reached out to experts who helped us decode the reason behind the disproportionately-high rate of cardiac arrests and heart attacks in the wee hours.
“We often see many heart patients coming in with a cardiac arrest or a heart attack early in the morning,” Dr TS Kler, Chairman (Fortis Heart and Vascular Institute) Fortis Memorial Research Institute, Gurugram said. According to the expert, it is due to the release of hormones in the body. “During early morning, around 4 am, our body experiences the release of cytokinin which can cause arrhythmia and increase the likelihood of sudden cardiac arrest,” he said.
According to a study by researchers at Brigham and Women’s Hospital and the Oregon Health and Science University, it is our body’s internal clock that is to be blamed. Agreeing, Dr Niti Chadha Negi, Senior Consultant Cardiologist, Head – Cardiac Electrophysiology, Metro Heart Hospital, Faridabad, explained that our body has a biological clock that helps us respond to our daily needs.
“During the day, we are more alert and efficient, while at night, we have used up all our energy and are ready for some much-needed sleep. Due to this biological clock, in the early morning hours, we see a rise in blood pressure and heart rate as a response to morning sympathetic surge,” he said. This rise in heart rates and blood pressure in response to the circadian rhythms makes the cardiovascular system more irritable during the mornings.
Concurring that “circadian rhythms are to blame for deadly or near-fatal strokes or attacks in the early morning”, Dr Anand Kumar Pandey, Director and Senior Consultant- Cardiology, Dharamshila Narayana Superspeciality Hospital added that most cardiac arrests occur between 4 and 10 am when blood platelets are stickier and increased adrenaline generated from the adrenal glands can cause plaque rupture in coronary arteries.
“The circadian system releases more PAI-1 cells in the morning, which prevent blood clots from breaking down. The greater the number of PAI-1 cells in the blood, the greater the chance of a blood clot leading to a heart attack or cardiac arrest,” he explained further.
“The morning time and the last stage of sleep are the riskiest times for heart attacks and all types of cardiovascular emergencies, including sudden cardiac death, aortic rupture or aneurysm, pulmonary embolism, and stroke,” Dr SS Sibia, Founder and Cardiologist, Sibia Medical Centre, Ludhiana said.
Another study, led by Queen Mary University of London, found that cardiovascular disease patients have lower levels of an important family of protective molecules in their blood in the morning. This could increase their risk of blood clots and heart attacks at those times.
Diabetes, hypertension, and regular smoking are some of the risk enhancers, making patients more likely to experience such an episode, experts said. “However, the current generation is seeing higher risks of heart attacks and cardiac arrests at an early age than before. Factors contributing to such increases in sudden cardiac arrests and resulting increased incidences of sudden death are erratic lifestyles, disturbed sleep-wake cycles, increased mental/ psychosocial stress, alcohol intake, unhealthy dietary habits along with air pollution,” Dr Negi added.
For good heart health, the cardiologists recommended getting at least 7-8 hours of sleep, maintaining a relatively stress-free life, creating slow-paced morning rituals and consuming a healthy diet.