It’s commonly believed that most heart attacks happen randomly. Maybe at night during sleep or while out walking alone. It’s also acknowledged that heart attacks are more likely to occur during periods of severe stress, such as during a natural disaster or even during periods of heightened emotions. There is however, a large body of research regarding the timing of heart attacks. It turns out we can predict the season, the day of the week, and even the time of the day that heart attacks are most likely to happen – even for the widowmaker, the most catastrophic of all heart attacks. Many studies encompassing thousands of patients have looked at this, and in this article we will review the major findings.
Which Season Has The Most Heart Attacks?
Several studies have demonstrated that there is seasonal variation in heart attacks.
They are most likely to occur in the winter, and least likely to occur in the summer. This is not just true for heart attacks, but also other cardiovascular events. Several explanations have been proposed. Winter is associated with infections and derangements in cholesterol levels. The lower temperatures cause increased stress on the walls of the heart and reduced flow to the arteries that supply the heart. Winter is also associated with psychological stress, depression and decreased activity. In fact, researchers have shown people are most likely to die from heart disease over the Christmas and New Years period.
What’s The Most Likely Day Of The Week To Have A Heart Attack?
Researchers have shown that people are clearly more likely to have a heart attack on a Monday. In fact the same goes for sudden cardiac death from life threatening heart rhythm problems, and death from other heart diseases. These findings are mainly true for the working population and hold true for men and women; however, this may not be true outside of the West. There is some evidence that in the Middle East the peak incidence of heart attacks is on Fridays, and in Japan it is during the weekend. This supports an explanation that relates to the working week and related stressors. It’s possible that increased stress hormones triggered by the return to work can make heart plaques unstable and lead to a heart attack. There is no clear proof of that however.
What’s The Most Likely Time Of Day To Have A Heart Attack?
It is well established that heart attacks are most likely to occur in the mornings and within the first few hours of waking. One study showed that you are three times likely of suffering a heart attack at 9am as compared to 11pm. Proposed reasons for this include increase surges of stress hormones on waking and also the blood being less thin in the morning, both of which have been demonstrated. Also the well-documented morning peaks in heart rate, blood pressure and blood vessel tone may contribute.
The Perfect Storm
Research has clearly demonstrated that far from being random, there is a pattern to peaks of incidence of cardiac events. Heart attacks, especially ST Segment Elevation Myocardial Infarctions, are most likely to happen in the winter months, on a Monday, and just after waking in the morning. Even worse would be a winter Monday morning in the setting of a natural disaster acting as a trigger. Statistically speaking, everyone at risk of heart disease should be a little on guard in such a scenario.
Should include real data, numbers and distributions, not just the words “more likely” and “most likely”. For example, I would like to see a plot of the number of heart attacks for men as a function age.
I have referenced multiple studies throughout that can be clicked on that will take you to the references that contain data, numbers and distributions. As you know, this is not a scientific peer review journal article nor is it intended to represent one.
I got a heart attack on 1st jan monday morning atb7 AM. Dr Mustafa your hypothesis is right.
you can follow my twitter at @MustafaAhmedMD
As a retired physician who is familiar with the fact of ‘early morning’ cardiac events, I continue to be amazed that I’ve never ever heard any clinician refer to the following fact:
Each morning, a part of our brain releases a well-known hormone: ACTH
(AdrenoCorticoTrophicHormone) whose main role is in keeping our adrenal glands healthy.
This release ocurs in the time block of perhaps 4am to some hours later.
Never mentioned is the fact that in medical research on the topic of hypertension test animals are infused with a substance to raise blood pressure … The substance?? ACTH !!! ..
fully capable of elevating BP very highly.
Why is it not obvious that this bolus of ACTH could play an important role in the issue at hand.
Further, it suggests that taking BP meds at night (which will usually result in a morning ‘blood level’ of the drug(s) to be higher .. perhaps offering some protection by lessening the elevation of BP in the morning, where ACTH-induced hypertension otherwise would be unopposed. HTN is associated with hearts that work harder: it takes ‘energy’ to raise fluid pressure in any system …
Ask your doctor for his/her advice… and if anyone can find documentation suggesting ACTH should be investigated for its possible role.
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I find this information quite interesting. I have just, within the past month, found out that the reason for my hypertension is an adrenal adenoma. I haven’t done much research on it and I know you wrote this comment several years ago, but I’m wondering if what you just talked about is a big reason my blood pressure is pretty high in the mornings despite taking meds at night. I take meds both in the morning and at night. This information has gave me something more to research. So thank you for your comment.