TEMPORAL PATTERNS OF STROKE ONSET - THE FRAMINGHAM-STUDY
TEMPORAL PATTERNS OF STROKE ONSET - THE FRAMINGHAM-STUDY
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DOI：
10.1161/01.str.26.8.1343
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发表时间：
1995-08-01
期刊：
影响因子：
8.3
通讯作者：
DAGOSTINO, RB
中科院分区：
文献类型：
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作者：
KELLYHAYES, M;WOLF, PA;DAGOSTINO, RB
背景和目的几项研究表明，中风的发病因季节、一周中的哪一天和一天中的不同时间而异。这些时间模式主要是在临床序列中发现的，它们可能会受到选择偏差的影响，为了获得较少扭曲的中风发病情况，我们在社区队列中检查了发生中风的月份和季节、星期几、时间和地点。方法在Framingham研究队列的40年监测期间，5070名年龄在30岁到62岁之间、入院时没有中风和心血管疾病的人中，有637人完成了首次中风。系统地确定卒中的月份、季节、星期、时间、发生地点，并与卒中发病率、亚型、性别进行前瞻性相关分析。周一发生的中风事件比其他任何一天都要多得多，特别是对上班族来说。对于脑内出血，三分之一的病例发生在周一，无论男女。一天中中风发生最频繁的时间是上午8点到中午。这一模式适用于所有中风亚型。当睡眠或醒来时发病的个体被排除在外时，这种模式仍然存在。一般情况下，卒中更多发生在家中，出血性卒中发生在家外，脑梗塞发生在医院比其他亚型更多。结论在以社区为基础的人群中，卒中发病存在季节、一周中的一天、一天中的时间和地点的时间模式。这些发现表明，中风的风险在某些时期增加，这可能是可以采取预防策略的。
Background and Purpose Several studies have shown stroke onset to vary by season, day of the week, and time of day. These temporal patterns, which may provide insights into pathogenesis, were found mainly in clinical series, which can be subject to selection bias, To obtain a less distorted picture of stroke onset, we examined the month and season, day of the week, time, and place stroke occurred in a community-based cohort.Methods Over a 40-year period of surveillance of the Framingham Study cohort of 5070 people aged 30 to 62 years and free of stroke and cardiovascular disease at entry, 637 completed initial strokes occurred. Month, season, day of the week, time of day, and place of occurrence of stroke were ascertained systematically and related prospectively to stroke incidence, subtype, and gender.Results Winter was the peak season for cerebral embolic strokes. Significantly more stroke events occurred on Mondays than any other day, particularly for working men. For intracerebral hemorrhages, a third happened on Mondays in both genders. The time of day when strokes most frequently occurred was between 8 AM and noon. This pattern was true for all stroke subtypes. This pattern persisted when individuals whose onset occurred while sleeping or on awakening were excluded. Stroke in general occurred more at home, with hemorrhagic strokes occurring outside the home and cerebral embolisms in the hospital more than other subtypes.Conclusions Temporal patterns of stroke onset were observed for season, day of the week, time of day, and place in a community-based population. These findings suggest that there are periods of increased risk of stroke that may be amenable to preventive strategies.