Unlocking the Potential of Circadian Biology for Cardiovascular Health

🥇 Top 1% JournalJan 7, 2026Physiological reviews

How Body Clock Biology May Improve Heart Health

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Major adverse cardiovascular events exhibit a distinct morning peak, highlighting the role of circadian rhythms in cardiovascular health.

Circadian rhythms regulate daily fluctuations in cardiovascular function, influencing blood pressure, cardiac metabolism, and repair processes.
Endogenous circadian rhythms independently affect blood pressure, autonomic nervous system activity, blood clotting, vascular tone, and metabolic function.
Disruptions in renal circadian rhythms may contribute to hypertension and heart failure progression.
Chronic circadian misalignment from shift work or irregular lifestyles is strongly associated with increased cardiovascular risk.
Circadian Medicine applies biological rhythms to clinical care, optimizing light exposure, meal timing, and physical activity.
Chronotherapy aligns treatment timing with a patient's circadian rhythms, potentially enhancing therapeutic outcomes.

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Circadian rhythms, governed by the body's endogenous clock mechanism, regulate daily fluctuations in cardiovascular function, optimizing physiological processes like blood pressure regulation, cardiac metabolism, and myocardial repair. Rhythms also align cardiovascular reactivity with predictable environmental and behavioral cycles, enabling normal function and affecting disease susceptibility. Major adverse cardiovascular events, including myocardial infarction, ventricular arrhythmias, and stroke, exhibit a distinct morning peak, highlighting circadian regulation in cardiovascular health. Controlled human laboratory studies demonstrate that beyond the influences of sleep and other behaviors, endogenous circadian rhythms independently regulate blood pressure, autonomic nervous system activity, blood clotting, vascular tone, and metabolic function. Additionally, the kidney plays a critical role in circadian sodium handling, fluid balance, and blood pressure control, with disruptions in renal circadian rhythms contributing to hypertension and progression to heart failure. Chronic circadian misalignment resulting from shift work, irregular sleep-wake cycles, or misaligned lifestyle habits is strongly associated with increased cardiovascular risk and disease progression. The emerging field of Circadian Medicine applies circadian principles to clinical care, leveraging interventions such as optimizing light exposure, meal timing, and physical activity to restore biological alignment. Chronotherapy, the strategic timing of medications or procedures to align with a patient's diurnal or circadian rhythms, offers further potential for enhancing treatments and reducing adverse effects. By integrating circadian biology into cardiovascular medicine, novel strategies are emerging to help prevent disease, improve patient outcomes, and enhance therapeutic precision. Understanding the interplay between circadian regulation and cardiovascular physiology provides a foundation for advancing cardiovascular prevention and treatment strategies.

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