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Updated: Sep 8, 2025

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Circadian rhythms in cardiovascular disease.

Ilse R Kelters1, Yvonne Koop2,3, Martin E Young4

  • 1Department of Cardiology and Experimental Cardiology Laboratory, Division of Heart & Lungs, University Medical Centre Utrecht, Heidelberglaan 11, 3584 CX Utrecht, The Netherlands.

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Circadian rhythms significantly impact cardiovascular health, influencing heart disease timing and outcomes. Understanding these biological clocks offers new opportunities for effective chronotherapy in treating heart conditions.

Keywords:
Cardiovascular DiseaseChronomodulationChronotherapyCircadian RhythmsEpidemiologyHeart FailureIncidenceMyocardial Infarctionischaemic Heart Disease

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Area of Science:

  • Cardiology
  • Chronobiology
  • Physiology

Background:

  • Circadian rhythms, governed by central and peripheral clocks, regulate 24-hour biological cycles, including cardiovascular function.
  • Autonomic balance shifts between sleep (parasympathetic dominance) and wakefulness (sympathetic activation), impacting cardiac recovery and circulatory demands.
  • 24-hour patterns are evident in the pathophysiology and clinical presentation of cardiovascular diseases.

Purpose of the Study:

  • To review the influence of circadian rhythms on cardiovascular health.
  • To examine the impact of circadian patterns on specific cardiac diseases and risk factors.
  • To highlight therapeutic opportunities offered by chronotherapy.

Main Methods:

  • Literature review of studies on circadian rhythms and cardiovascular health.
  • Analysis of daily variations in cardiovascular disease pathophysiology and outcomes.
  • Examination of risk factors and their interaction with circadian rhythms.

Main Results:

  • Circadian rhythms influence the timing, size, and outcome of myocardial infarction and other cardiovascular events.
  • Diseases like heart failure show dampened but intact circadian rhythms, suggesting therapeutic potential.
  • Sudden cardiac death incidence peaks in the morning, while atrial fibrillation onset is more frequent at night.

Conclusions:

  • Circadian rhythms play a critical role in cardiovascular health and disease.
  • Interactions between circadian rhythms and various risk factors affect cardiovascular pathomechanisms.
  • Chronotherapy, aligning treatments with circadian rhythms, shows promise for enhancing cardiovascular therapy efficacy.