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Title: Seasonal and diurnal variations in cardiovascular risk factors and cardiovascular disease in older British men
Author: Sartini, Claudio
ISNI:       0000 0004 8507 5633
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2019
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Cardiovascular disease (CVD) is the leading cause of death worldwide, and its prevalence is higher among older adults. Moreover, two different temporal variations in CVD risk exist: (i) seasonal: in Europe the CVD mortality risk is higher in winter, when outdoor temperatures are lower; (ii) diurnal: CVD deaths occur more frequently in the morning. However, biological pathways of both seasonal and diurnal variations in CVD mortality have not been fully understood. In part, this may be due to lack of understanding of variations of underlying CVD risk factors in older adults, especially inflammatory markers and physical activity. Investigating physical activity variations is of special interest, as new findings could also potentially shape the development of physical activity guidelines for older people. The aims of this thesis are twofold: (i) to investigate seasonal variations in CVD risk factors and mortality, by using outdoor temperature as the main exposure variable and seasonal factor of interest; ii) to investigate time of day variations of CVD risk factors. To achieve these objectives, data from the British Regional Heart Study of older adults were used. Seasonal variation findings: lower outdoor temperatures were especially associated with higher blood pressure, higher LDL-Cholesterol, higher IL-6, lower physical activity levels, and with increased CVD and respiratory mortality. In conclusion, better protection against low temperatures, as well as staying active during cold weather, could help in reducing the CVD risk in older adults. Diurnal variation findings: some CVD risk factors levels, especially blood pressure, LDL-Cholesterol and IL-6, increased linearly over the course of the daytime (in between 08:00-19:00 hours). Future studies aiming to understand the causal pathways of the diurnal variation in CVD events could focus especially on these markers' variations. Also, physical activity levels peaked in the morning, and initiatives encouraging more active behaviours in the afternoon/evening are needed.
Supervisor: Morris, R. ; Jefferis, B. ; Wannamethee, S. ; Whincup, P. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available