What time of day is a heart attack more likely and how to avoid it

The worst times for heart attack and for all kinds of cardiovascular emergency are the mornings and during the last phase of sleep.

No, you can't sleep at a different time.  The danger period is just before you wake up and just after you wake up. We do say mornings but shift workers have exactly the same problem. Regardless of the time you sleep  the short time before you wake up you are in the dream time part of your sleep when you might imagine danger or running or whatever and your heart starts up from its resting mode while you are in deep sleep and do not need everything powered up. Then when you wake up the heart rate increases because you need to sit up or get out of bed and start your day.

What actually happens.

Starting your day requires more myocardial oxygen support to wake up and commence physical activities. The adrenal hormone cortisol increases to boost blood-pressure and blood-sugar levels and blood pressure and heart rate peaks when you wake up. All of these changes lead to an increase of oxygen consumption but at the same time contribute to the constriction of blood vessels. This reduced vessel size and reduced blood flow to the coronary vessels together with you blood being slightly thicker means that at the time that you need more blood flow, you have less. All of these changes are not so harmful in healthy people, however, anyone with a medical problem in their cardio-vascular system have a higher risk of heart attack during that specific window of hours before waking and getting up.

What can we do about this?

We can't be afraid of the various processes and the peak in blood pressure in the morning. It's part of our physiology and for healthy people, it's not a problem.

For people with cardiovascular problems they should have a talk to their doctor


It's important for doctors, however, to remember this risk of morning heart attack when they give medication. Usually people take their medicine in the morning, when they wake up. However, this is already inside the higher-risk period but when you think about it, this is also at the same time the medicine has reached the last hour of its usefulness having been taken nearly 24 hours before. Not all pills give 24-hour coverage and some of them have a short half-life (A 6-hour half-life means that after 6 hours it is only half of full strength) 

Makes sense to ask if the medicine you are taking are still active when they are needed most. It’s not easy because if you take them at night you may lower your normally low night time blood pressure and heart rate too much and this runs the risk of not getting enough blood to your brain, or your heart rate is too low. Your doctor will advise you, or possibly change your medications to get a better half-life, or have it twice a day, or even suggest a different size dose for morning and night. Another way is to consider changing the time of medication. Timing is very important.

What else to avoid a heart attack


Here is a list of a few suggestions from readers that sound reasonable but again check with your doctor and obtain advice.

  • From China
    • Get up routine
      • Open your eyes and lie down for 10 minutes.
      • First move your fingers and toes in 10 minutes, then move your legs and arms, then take a deep breath and massage your head, chest and abdomen with your hands
      • After 10 minutes, sit up and get out of bed
    • Drink 3 glasses of water
      • 1 small glass half an hour before bedtime
      • If you wake up in middle of night drink another small glass
      • When you wake up drink one glass
    • Eat one egg per day
      • (Egg yolks are rich in vitamin E, vitamin B12, and folic acid, which play a key role in preventing heart disease.)
    • From many
      • Lose weight
      • Don’t drink too much alcohol
      • Don't do drugs of addiction
      • Get enough sleep everyday
      • Aerobic exercise two or three times a week (Do not do excessive exercise. Movement important)
      • Meditate for 20 minutes every day
        • Reducing stress can help reduce the risk of death from coronary heart disease.