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March 30, 2026Journal of Stroke and Cerebrovascular Diseases0 citationsOpen Access

Evolution of Circadian Syndrome status and Risk of Incident Stroke: A Longitudinal Cohort Study of Chinese Middle-Aged and Older Adults

PKPeiling KEJHJinglong HuangLSLinjie SU

Key Points

  • The study aims to investigate the relationship between circadian syndrome status and the incidence of stroke over time.
  • Analyzed data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020.
  • Included 8,035 adults aged 40 years and older to assess baseline Circadian Syndrome and stroke incidence.
  • Evaluated changes in CircS status in a subset of 4,054 participants using Cox proportional hazards models.
  • Participants with Circadian Syndrome had a higher stroke incidence of 1.43 per 1,000 person-years compared to 0.69 for those without.
  • Adjusted hazard ratios indicated that resolved CircS had aHR of 2.20, incident CircS aHR of 2.33, and persistent CircS aHR of 2.87 for stroke risk.
  • Associations with stroke risk persisted across different demographic and behavioral subgroups.

Abstract

Background: Circadian Syndrome (CircS), encompassing cardiometabolic and behavioral disruptions, has emerged as a potential risk factor for vascular disease.However, its longitudinal impact on stroke incidence remains unclear.Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS, 2011(CHARLS, -2020)), we examined the association between baseline CircS and incident stroke among 8,035 Chinese adults aged 40 years.A subset of 4,054 participants was analyzed to evaluate changes in CircS status and subsequent stroke risk.Cox proportional hazards models adjusted for demographic and clinical covariates were employed.Results: At baseline, participants with CircS had a significantly higher stroke incidence (1.43 vs. 0.69 per 1,000 person-years; adjusted hazard ratio (aHR): 2.18, 95% CI: 1.88-2.53).Compared to those with persistently normal CircS status, individuals with resolved (aHR: 2.20, 95% CI: 1.61-3.02),incident (aHR: 2.33, 95% CI: 1.66-3.28),and persistent CircS (aHR: 2.87, 95% CI: 2.19-3.77)exhibited progressively elevated risks of stroke.Associations remained consistent across age, sex, and behavioral subgroups.Conclusions: CircS and its dynamic evolution are strongly associated with incident stroke.Individuals with persistent CircS face the highest risk, while risk remains elevated even after resolution.

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Cite This Study

KE et al. (2026) studied this question.

synapsesocial.com/papers/69ca1280883daed6ee094fddhttps://doi.org/10.1016/j.jstrokecerebrovasdis.2026.108621
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