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Hypertension: Causes and Consequences of Circadian Rhythms in Blood Pressure
Frank M Faraci1,2, Frank A J L Scheer3,4,5,6
1Department of Internal Medicine (F.M.F.), Francois M. Abboud Cardiovascular Center, Carver College of Medicine, University of Iowa.
Insights
Circadian biology significantly impacts blood pressure regulation and hypertension. Understanding these biological rhythms offers new avenues for treating hypertension and its cardiovascular consequences.
Area of Science:
- Cardiovascular Science
- Chronobiology
- Hypertension Research
Background:
- Hypertension affects nearly half of adults globally, serving as a primary risk factor for cardiovascular disease and mortality.
- Despite extensive research, the role of circadian biology in hypertension mechanisms remains underexplored.
- Biological rhythms influence physiological processes from the genome to the whole organism, but their impact on hypertension is not well-defined.
Purpose of the Study:
- To review the influence of daily rhythms and circadian systems on blood pressure regulation.
- To examine the role of circadian biology in the onset, progression, and consequences of hypertension.
- To highlight the connection between circadian biology, vascular disease, and end-organ damage.
Main Methods:
- Literature review focusing on preclinical models and human studies.
- Analysis of existing research on circadian patterns and blood pressure.
- Synthesis of data on circadian misalignment and its effects.
Main Results:
- Circadian systems play a crucial role in regulating daily blood pressure patterns.
- Circadian misalignment is linked to hypertension development and progression.
- Disrupted circadian biology contributes to vascular disease and end-organ damage, including cognitive decline and cardiac/brain health loss.
Conclusions:
- Circadian biology is a critical, yet often overlooked, factor in hypertension.
- Understanding circadian mechanisms can lead to novel therapeutic strategies for hypertension management.
- Further research into circadian rhythms may improve prevention and treatment of hypertension and related pathologies.
Abstract:
Hypertension is extremely common, affecting approximately 1 in every 2 adults globally. Chronic hypertension is the leading modifiable risk factor for cardiovascular disease and premature mortality worldwide. Despite considerable efforts to define mechanisms that underlie hypertension, a potentially major component of the disease, the role of circadian biology has been relatively overlooked in both preclinical models and humans. Although the presence of daily and circadian patterns has been observed from the level of the genome to the whole organism, the functional and structural impact of biological rhythms, including mechanisms such as circadian misalignment, remains relatively poorly defined. Here, we review the impact of daily rhythms and circadian systems in regulating blood pressure and the onset, progression, and consequences of hypertension. There is an emphasis on the impact of circadian biology in relation to vascular disease and end-organ effects that, individually or in combination, contribute to complex phenotypes such as cognitive decline and the loss of cardiac and brain health. Despite effective treatment options for some individuals, control of blood pressure remains inadequate in a substantial portion of the hypertensive population. Greater insight into circadian biology may form a foundation for novel and more widely effective molecular therapies or interventions to help in the prevention, treatment, and management of hypertension and its related pathophysiology.
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