Circadian rhythms in cardiovascular (dys)function: approaches for future therapeutics

The circadian clock is an evolutionarily conserved time-keeper that regulates physiological processes across 24 h. In the cardiovascular system, several parameters, such as blood pressure, heart rate, and metabolism, exhibit time-of-day variations. These features are in part driven by the circadian clock. Chronic perturbation of diurnal rhythmicity due to shift work or irregular social schedules has been associated with an increased risk of hypertension, arrhythmias, and myocardial infarction. This review discusses the impact of circadian rhythms on human cardiovascular health and the effect of clock disruption on the occurrence of adverse cardiac events. Additionally, we discuss how the main risk factors of cardiovascular diseases, such as obesity, sleep disorders, and aging, affect circadian rhythms. Finally, we elaborate on chronotherapy as well as on targeting the clock and highlight novel approaches to translate our scientific understanding of the circadian clock into clinical practice.