We studied the chronobiologic pattern of heart rate, R and T wave voltage, QT interval, and ST segment displacement. Premature atrial and ventricular beats obtained by dynamic electrocardiography, as well as arterial blood pressure measurements obtained by autometry, have also been studied in 131 untreated subjects (25 with hypertension, 28 with major risk factors for coronary artery disease, 9 with coronary artery disease, 37 presumably healthy and 11 shift workers). Our results show the existence of circadian rhythms in heart rate, in the duration of the QT interval and also in the voltage of R and T waves. Our data for R and T wave voltages do not completely agree with those from other authors. We demonstrated also that smoking may influence the circadian acrophase of the rhythm in R wave voltage while sleeping does not show any relationship with R and T wave voltages although it seems related to the displacement of the ST segment. We could point out only small differences in the chronobiologic behavior of patients with coronary disease and that of normal subjects, unlike the results previously reported by other authors. Our study demonstrated the existence of circadian and ultradian rhythms in premature atrial and ventricular beats as well as circadian and circaseptan rhythms in arterial blood pressure. Further studies are needed to improve our chronobiologic knowledge in order to optimize dosage and time of administration of the drugs used in the long term management of arrhythmias and hypertension.
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