Chronobiological Influence over Cardiovascular Function: The Good, the Bad, and the Ugly

Samir Rana, Sumanth D. Prabhu, Martin E. Young

Research output: Contribution to journalReview articlepeer-review

51 Scopus citations


Essentially all biological processes fluctuate over the course of the day, observed at cellular (eg, transcription, translation, and signaling), organ (eg, contractility and metabolism), and whole-body (eg, physical activity and appetite) levels. It is, therefore, not surprising that both cardiovascular physiology (eg, heart rate and blood pressure) and pathophysiology (eg, onset of adverse cardiovascular events) oscillate during the 24-hour day. Chronobiological influence over biological processes involves a complex interaction of factors that are extrinsic (eg, neurohumoral factors) and intrinsic (eg, circadian clocks) to cells. Here, we focus on circadian governance of 6 fundamentally important processes: metabolism, signaling, electrophysiology, extracellular matrix, clotting, and inflammation. In each case, we discuss (1) the physiological significance for circadian regulation of these processes (ie, the good); (2) the pathological consequence of circadian governance impairment (ie, the bad); and (3) whether persistence/augmentation of circadian influences contribute to pathogenesis during distinct disease states (ie, the ugly). Finally, the translational impact of chronobiology on cardiovascular disease is highlighted.

Original languageEnglish
Pages (from-to)258-279
Number of pages22
JournalCirculation research
Issue number2
StatePublished - Jan 17 2020


  • blood pressure
  • electrophysiology
  • extracellular matrix
  • inflammation
  • metabolism


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