Cardiologist Explains the Most Dangerous Time of Day for Heart Attacks and Strokes

Anna O. Mahovikova, Head of the Outpatient Cardiology Department at the Clinic of High Medical Technologies named after N.I. Pirogov at St. Petersburg State University, appeared on the television program «Morning in St. Petersburg» to explain when the risk of exacerbation of chronic diseases and the development of acute conditions — such as myocardial infarction and stroke — is at its highest.

During the interview, Anna Mahovikova noted that these high-risk periods are closely linked to human circadian rhythms — daily fluctuations in hormone levels and biologically active substances. In the pre-dawn and early morning hours, a pronounced surge of cortisol and adrenaline occurs, preparing the body for awakening. This process is accompanied by increases in blood pressure, heart rate, and blood coagulability, significantly raising the likelihood of serious cardiovascular complications.

The expert подробно outlined the daily risk patterns for various disease groups. For the cardiovascular system, including myocardial infarction and stroke, the peak risk occurs in the morning hours. For patients with diabetes mellitus, the most dangerous period is nighttime, when the risk of severe hypoglycemia is highest. In contrast, flare-ups of inflammatory joint diseases such as arthritis are more common after waking, due to prolonged nocturnal immobility and increased levels of inflammatory markers.

The physician also provided practical recommendations for risk reduction, emphasizing the importance of evening self-monitoring. These include regular blood pressure measurement, glucose level control, adherence to prescribed medications, and maintaining a calm psychological state before sleep.

Cardiologists and internists at the Center of Cardiac Surgery at St. Petersburg State University provide comprehensive diagnostics, treatment, and prevention of cardiovascular diseases — from acute conditions such as myocardial infarction, hypertensive crisis, and acute heart failure to chronic disorders including coronary artery disease, arterial hypertension, and chronic heart failure. Special attention is given to prevention through individualized risk-factor management programs, continuous health monitoring, and patient education in effective self-care strategies.

Anna Mahovikova has previously addressed modern approaches to the prevention of coronary artery disease — a chronic condition that may progress silently for years and lead to life-threatening complications — in a dedicated lecture. A comprehensive preventive strategy allows risks to be identified early and cardiovascular disease progression to be actively prevented, helping patients maintain a high quality of life for many years.