Further studies assessing both CVD risk factors levels and clinical outcomes (eg, fatal or non-fatal CVD events) during 24 hours are required to demonstrate whether a rapid increase of IL-6 over the day may be relevant to the increased number of CVD events observed in early and late morning,30 and whether the increased levels of NT-proBNP over the day are related to the afternoon peak in sudden death following heart failure.31 This evidence concerns the gene NPPB and heart failure.