Hypertension (Dallas, Tex. : 1979)Nov 30, 2022

Timing of Blood Pressure Changes and Treatment to Lower High Blood Pressure

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 28, 2026

Abstract

Healthy individuals show higher blood pressure during wakefulness and lower blood pressure during sleep.

Loss of the blood pressure circadian rhythm may be linked to negative health outcomes, including cardiovascular disease and dementia.
Current diagnostic and treatment methods often overlook the importance of blood pressure's circadian patterns.
Factors such as sleep, hormone levels, diet, and body temperature are associated with circadian rhythms that can affect blood pressure.
Nonpharmacologic interventions like meal timing and pharmacologic approaches such as nighttime antihypertensive medication have been suggested to optimize blood pressure control.
The underlying mechanisms of how circadian rhythms regulate blood pressure and the effectiveness of these treatment strategies are still not fully understood.

Simplified

Healthy individuals exhibit blood pressure variation over a 24-hour period with higher blood pressure during wakefulness and lower blood pressure during sleep. Loss or disruption of the blood pressure circadian rhythm has been linked to adverse health outcomes, for example, cardiovascular disease, dementia, and chronic kidney disease. However, the current diagnostic and therapeutic approaches lack sufficient attention to the circadian rhythmicity of blood pressure. Sleep patterns, hormone release, eating habits, digestion, body temperature, renal and cardiovascular function, and other important host functions as well as gut microbiota exhibit circadian rhythms, and influence circadian rhythms of blood pressure. Potential benefits of nonpharmacologic interventions such as meal timing, and pharmacologic chronotherapeutic interventions, such as the bedtime administration of antihypertensive medications, have recently been suggested in some studies. However, the mechanisms underlying circadian rhythm-mediated blood pressure regulation and the efficacy of chronotherapy in hypertension remain unclear. This review summarizes the results of the National Heart, Lung, and Blood Institute workshop convened on October 27 to 29, 2021 to assess knowledge gaps and research opportunities in the study of circadian rhythm of blood pressure and chronotherapy for hypertension.

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Competing interests

Conflict of Interest : The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services.

PubMed

Timing of Blood Pressure Changes and Treatment to Lower High Blood Pressure

Abstract

Full Text

Funding

Competing interests

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