Abstract
Background Aortic Aneurysm (AA) is a common atherosclerotic condition,
accounting for nearly 6,000 deaths in England and up to 175,000 deaths
globally each year. The pathological outward bulging of the aorta
typically results from atherosclerosis or hereditary connective tissue
disorders. AAs are usually asymptomatic until spontaneous rupture or
detected on incidental screening. 8 in 10 patients do not survive the
rupture and die either before reaching hospital or from complications
following surgery. Similar to other cardiovascular pathologies (CVPs),
AA is thought to be subject to chronobiological patterns of varying
incidence. Methods We performed a literature review of the current
literature to evaluate the association between circadian rhythms,
seasonal variations, and genetic factors and the pathogenesis of AA,
reviewing the impact of chronobiology. Results The incidence of AA is
found to peak in the early morning (6 AM – 11 AM) and colder months,
and conversely troughs towards the evening and warmer months, exhibiting
a similar pattern of chronobiological rhythm as other CVPs such as
myocardial infarcts, or cerebrovascular strokes. Conclusion Literature
suggests there exists a clear relationship between chronobiology and the
incidence and pathogenesis of ruptured AA; incidence increases in the
morning (6am - 11am), and during colder months (December – January).
This is more pronounced in patients with Marfan Syndrome, or vitamin D
deficiency. The underlying pathophysiology and implications this has for
chronotherapeutics, are also discussed. Our review shows a clear need
for further research into the chronotherapeutic approach to preventing
ruptured AA in the journey towards precision medicine.