Autonomic nervous system: an integrative regulator in circadian rhythm of blood pressure

Circadian rhythms, fundamental biological oscillations aligning physiological functions with the Earth's 24-h cycle, profoundly influence blood pressure (BP) regulation. In this review, we first consolidates current understanding the systemic and cellular organizations of circadian clocks. Next, we delve into the intricate relationship between BP and circadian rhythms, examining how environmental cues like light, sleep, and diet disrupt these rhythms, leading to BP disorders. Crucially, we emphasize the ANS's central role as a dynamic integrator, mediating the influence of central and peripheral circadian clocks on BP, and facilitating crosstalk with other major BP regulatory systems like the renin-angiotensin-aldosterone system (RAAS), natriuretic peptides (NP), and the immune system. Finally, we presented a future perspective of research on ANS function in the circadian rhythm of BP, identifying key unresolved questions and proposed therapies based on mechanisms for hypertension induced by ANS disorders. Overall, this is a comprehensive review elucidating ANS tone as a pivotal mechanism underlying the circadian rhythm of blood pressure.