Role of the circadian system in cardiovascular disease

Jun 2, 2018The Journal of clinical investigation

How the body’s internal clock is linked to heart and blood vessel disease

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Abstract

Cardiovascular events such as stroke and myocardial infarction frequently occur in the morning.

Circadian rhythms in the body help prepare the cardiovascular system for daily activity patterns.
Morning responses of the cardiovascular system may support the transition from sleep to wakefulness.
Exaggerated cardiovascular responses in the morning could increase risk for individuals prone to events like heart attacks.
Chronic disruptions of the circadian clock, such as those experienced by night-shift workers, may elevate cardiovascular risk.
Understanding the circadian system's role is essential for improving cardiovascular function and managing cardiovascular diseases.

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All species organize behaviors to optimally match daily changes in the environment, leading to pronounced activity/rest cycles that track the light/dark cycle. Endogenous, approximately 24-hour circadian rhythms in the brain, autonomic nervous system, heart, and vasculature prepare the cardiovascular system for optimal function during these anticipated behavioral cycles. Cardiovascular circadian rhythms, however, may be a double-edged sword. The normal amplified responses in the morning may aid the transition from sleep to activity, but such exaggerated responses are potentially perilous in individuals susceptible to adverse cardiovascular events. Indeed, the occurrence of stroke, myocardial infarction, and sudden cardiac death all have daily patterns, striking most frequently in the morning. Furthermore, chronic disruptions of the circadian clock, as with night-shift work, contribute to increased cardiovascular risk. Here we highlight the importance of the circadian system to normal cardiovascular function and to cardiovascular disease, and identify opportunities for optimizing timing of medications in cardiovascular disease.

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Role of the circadian system in cardiovascular disease

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