Online CME . Related to this surge in catecholamines, platelet aggregation or adhesiveness and blood viscosity tend to be high in the morning. Aldosterone and angiotensin levels also tend to be highest in the early morning, contributing to the increase in peripheral resistance. In contrast, insulin levels tend to peak in the late afternoon, while triglyceride and cholesterol levels peak more in the early or mid-evening.
Gastric secretion is highest in the late evening, tending to peak around midnight.
Circadian Rhythms and Pathologic Processes Several well-defined pathologic processes are characterized by a circadian pattern. Migraine headaches, allergic rhinitis, and rheumatoid arthritis symptoms all tend to be worse in the morning. Angina, silent ischemic, acute myocardial infarction, sudden cardiac death, and ischemic stroke are more likely to occur between 6 a.m. and noon. The concept of chronotherapy is the tailoring of treatment to the indigenous rhythm in order to maximize benefit. The concept of chronotherapy is already applied in many areas.