Excess in cardiovascular events on Mondays: a meta-analysis and prospective study
- Correspondence to: Dr A G Barnett School of Population Health, University of Queensland, Herston, QLD 4006, Australia; a.barnettsph.uq.edu.au
- Accepted 23 April 2004
Abstract
The aim of this paper was to summarise the reported excess in coronary events on Mondays, and examine the evidence for three competing explanations: stress, alcohol consumption, or registration errors. A review of the literature found 28 studies covering 16 countries and over 1.6 million coronary events. The overall Monday excess was small; in a population experiencing 100 coronary events per week there was one more event on Monday than other days. The excess was larger in men and in studies including sudden cardiac death or cardiac arrests. In a prospective study an increase in events on Mondays was associated with greater alcohol consumption, lower rainfall, and the month of January. The excess in coronary events on Mondays is a persistent phenomenon. The size of the effect varies widely between populations. There is some evidence of an association with alcohol consumption, but a definitive explanation remains elusive and is likely to remain so because of the smallness of the effect and the paucity of high quality data.
Footnotes
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Funding: this work was funded by the National Health and Medical Research Council of Australia (grant numbers 100954 and 252834).
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Conflicts of interest: none declared.
