Document Detail


Circadian variation in the circulatory responses to exercise: relevance to the morning peaks in strokes and cardiac events.
MedLine Citation:
PMID:  19826832     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sudden cardiac and cerebral events are most common in the morning. A fundamental question is whether these events are triggered by the increase in physical activity after waking, and/or a result of circadian variation in the responses of circulatory function to exercise. Although signaling pathways from the master circadian clock in the suprachiasmatic nuclei to sites of circulatory control are not yet understood, it is known that cerebral blood flow, autoregulation and cerebrovascular reactivity to changes in CO(2) are impaired in the morning and, therefore, could explain the increased risk of cerebrovascular events. Blood pressure (BP) and the rate pressure product (RPP) show marked 'morning surges' when people are studied in free-living conditions, making the rupture of a fragile atherosclerotic plaque and sudden cardiac event more likely. Since cerebral autoregulation is reduced in the morning, this surge in BP may also exacerbate the risk of hemorrhagic and ischemic strokes in the presence of other acute and chronic risk factors. Increased sympathetic activity, decreased endothelial function, and increased platelet aggregability could also be important in explaining the morning peak in cardiac and cerebral events but how these factors respond to exercise at different times of day is unclear. Evidence is emerging that the exercise-related responses of BP and RPP are increased in the morning when prior sleep is controlled. We recommend that such 'semi-constant routine' protocols are employed to examine the relative influence of the body clock and exogenous factors on the 24-h variation in other circulatory factors.
Authors:
Greg Atkinson; Helen Jones; Philip N Ainslie
Publication Detail:
Type:  Journal Article     Date:  2009-10-14
Journal Detail:
Title:  European journal of applied physiology     Volume:  108     ISSN:  1439-6327     ISO Abbreviation:  Eur. J. Appl. Physiol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-04-30     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  100954790     Medline TA:  Eur J Appl Physiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  15-29     Citation Subset:  IM    
Affiliation:
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK. g.atkinson@ljmu.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Blood Flow Velocity / physiology
Blood Pressure / physiology
Brain / physiology
Brain Ischemia / epidemiology,  physiopathology
Cerebrovascular Circulation / physiology
Circadian Rhythm / physiology*
Endothelium, Vascular
Exercise / physiology*
Hand Strength
Humans
Motor Activity / physiology
Myocardial Infarction / epidemiology*
Physical Endurance / physiology
Physical Exertion
Risk Factors
Sleep
Stroke / epidemiology,  physiopathology*
Suprachiasmatic Nucleus / physiopathology
Sympathetic Nervous System / physiology*
Time Factors
Grant Support
ID/Acronym/Agency:
G0501286(75373)//Medical Research Council
Comments/Corrections

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