| Authors |
Shea SA, Scheer FAJL, Gumz ML, Eikenberry SA, Qian J, Thosar SS, Sole MJ,
Martino TA
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| Submitted By |
Michelle Gumz on 8/19/2026 |
| Status |
Published |
| Journal |
Physiological reviews |
| Year |
2026 |
| Date Published |
7/1/2026 |
| Volume : Pages |
106 : 1195 - 1262 |
| PubMed Reference |
41500519 |
| Abstract |
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, with evidence for circadian regulation in cardiovascular health.
Indeed, 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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