Abstract

Introduction: Previous studies have shown inconsistent changes in the rates of adverse cardiovascular events after daylight savings time (DST) transitions. In this large-scale, U.S.-based nationwide study, we sought to investigate the association of DST transitions with the rates of adverse cardiovascular events. Methods: The study cohort included 36,116,951 unique individuals from de-identified administrative claims data of the OptumLabs Data Warehouse®. There were 74,722 total adverse cardiovascular events during the week of DST transition and the control weeks (two weeks prior and after) in spring and autumn of 2015-2019. We used Bayesian hierarchical Poisson regression models to estimate the event rate ratios (ERR) representing the ratio of composite adverse cardiovascular event rates (acute myocardial infarction, stroke, cardiogenic shock, cardiac arrest, and sudden death) between DST transition weeks and control weeks. Results: Our results showed an average increase of 3% [95% uncertainty interval; -3% to 10%] and 4% [-2% to 12%] in the rate of adverse cardiovascular events during Monday and Friday of the spring DST transition week, respectively. The probability of spring DST transition being associated with a moderate-to-large increase in the event rates (ERR>1.10) was estimated to be <6% for Monday and Friday, and <1% for the remaining days. During autumn DST transition, the probability of any decrease in adverse cardiovascular event rates was estimated to be <46% and a moderate-to-large decrease in the event rates to be <4% across all days of the week. Conclusions: Spring DST transition week had a suggestive association with a minor increase in adverse cardiovascular event rates on Monday and Friday. The probability of this association to be of clinically meaningful magnitude was estimated to be very low. We did not observe any evidence suggestive of a change in adverse cardiovascular event rates immediately following autumn DST transition. Taken together, our findings, based on a large, diverse cohort from across the United States, suggest that DST transitions are unlikely to significantly impact the rate of cardiovascular events.

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