心血管疾病的昼夜节律：阿司匹林时辰治疗的潜力
Circadian Rhythm of Cardiovascular Disease: The Potential of Chronotherapy With Aspirin.
作者信息
Buurma Marleen, van Diemen Jeske J K, Thijs Abel, Numans Mattijs E, Bonten Tobias N
机构信息
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands.
出版信息
Front Cardiovasc Med. 2019 Jun 20;6:84. doi: 10.3389/fcvm.2019.00084. eCollection 2019.
Almost all the systems in our body adhere to a daily 24 h rhythm. The cardiovascular system is also affected by this 24 h rhythm. In the morning there is a change in various cardiovascular processes, including platelet aggregability. These changes may play a role in the relative excess of early morning cardiovascular events. The number of recurrent cardiovascular diseases (CVD) could, in theory, be reduced by responding to this 24 h rhythm with timed medication intake (chronotherapy), which also applies to aspirin. Multiple studies on chronotherapy with low-dose aspirin are promising, showing a decrease in early morning platelet activity with evening intake compared with morning intake. However, in order to further demonstrate its clinical impact, randomized trials with cardiovascular events as a primary outcome are needed. This review discusses the available evidence of the effects of circadian rhythm on CVD and the potential positive effect of chronotherapy with aspirin.
我们身体里几乎所有的系统都遵循每日24小时的节律。心血管系统也受这24小时节律的影响。早晨，包括血小板聚集性在内的各种心血管过程会发生变化。这些变化可能在清晨心血管事件相对高发中起作用。理论上，通过定时服药（时间治疗法）来顺应这24小时节律，复发性心血管疾病（CVD）的数量可能会减少，这也适用于阿司匹林。多项关于小剂量阿司匹林时间治疗法的研究很有前景，与早晨服药相比，晚上服药可使清晨血小板活性降低。然而，为了进一步证明其临床影响，需要以心血管事件作为主要结局的随机试验。本综述讨论了昼夜节律对心血管疾病影响的现有证据以及阿司匹林时间治疗法的潜在积极作用。
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