Associations of time of day with cardiovascular disease risk factors measured in older men: results from the British Regional Heart Study

Sartini, C., Whincup, P. H., Wannamethee, S. G., Jefferis, B. J., Lennon, L., Lowe, G. D.O., Welsh, P. , Sattar, N. and Morris, R. W. (2017) Associations of time of day with cardiovascular disease risk factors measured in older men: results from the British Regional Heart Study. BMJ Open, 7(11), e018264. (doi:10.1136/bmjopen-2017-018264) (PMID:29133328) (PMCID:PMC5695475)

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Abstract

Objective: We estimated associations of time of day with cardiovascular disease (CVD) risk factors measured in older men. Methods: CVD risk factors (markers of inflammation and haemostasis, and cardiac markers) were measured on one occasion between 08:00 and 19:00 hours in 4252 men aged 60–79 years from the British Regional Heart Study. Linear models were used to estimate associations between time of day and risk factors. When an association was found, we examined whether the relationship between risk factors and cardiovascular mortality was affected by the adjustment for time of day using survival analyses. Results: N-terminal pro-brain natriuretic peptide (NT-proBNP) levels increased by 3.3% per hour (95% CI 1.9% to 4.8%), interleukin-6 (IL-6) increased by 2.6% per hour (95% CI 1.8% to 3.4%), while tissue plasminogen activator (t-PA) decreased by 3.3% per hour (95% CI 3.7% to 2.9%); these associations were unaffected by adjustment for possible confounding factors. The percentages of variation in these risk factors attributable to time of day were less than 2%. In survival analyses, the association of IL-6, NT-proBNP and t-PA with cardiovascular mortality was not affected by the adjustment for time of day. C reactive protein, fibrinogen, D-dimer, von Willebrand factor and cardiac troponin T showed no associations with time of day. Conclusions: In older men, markers of inflammation (IL-6), haemostasis (t-PA) and a cardiac marker (NT-proBNP) varied by time of day. The contribution of time of day to variations in these markers was small and did not appear to be relevant for the CVD risk prediction.

Item Type:Articles
Additional Information:The BRHS is supported by a British Heart Foundation (BHF) programme grant (RG/13/16/30528). This research was supported by a BHF project grant (PG/13/41/30304), which supported CS.
Keywords:Biological markers, cardiovascular disease, diurnal variations, older adults.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Welsh, Dr Paul and Lowe, Professor Gordon and Sattar, Professor Naveed
Authors: Sartini, C., Whincup, P. H., Wannamethee, S. G., Jefferis, B. J., Lennon, L., Lowe, G. D.O., Welsh, P., Sattar, N., and Morris, R. W.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:12 November 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in BMJ Open 7(11): e018264
Publisher Policy:Reproduced under a Creative Commons License

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