Chronobiology

CLOCK

Molecular clock

Neuroscience

Disease

Circadian clock

Biology

Phylogenetics

Gene

Bacterial circadian rhythms

Circadian rhythm

Internal medicine

Physiology

Genetics

Medicine

Nature Reviews Cardiology

The Earth turns on its axis every 24 h; almost all life on the planet has a mechanism — circadian rhythmicity — to anticipate the daily changes caused by this rotation. The molecular clocks that control circadian rhythms are being revealed as important regulators of physiology and disease. In humans, circadian rhythms have been studied extensively in the cardiovascular system. Many cardiovascular functions, such as endothelial function, thrombus formation, blood pressure and heart rate, are now known to be regulated by the circadian clock. Additionally, the onset of acute myocardial infarction, stroke, arrhythmias and other adverse cardiovascular events show circadian rhythmicity. In this Review, we summarize the role of the circadian clock in all major cardiovascular cell types and organs. Second, we discuss the role of circadian rhythms in cardiovascular physiology and disease. Finally, we postulate how circadian rhythms can serve as a therapeutic target by exploiting or altering molecular time to improve existing therapies and develop novel ones. Many cardiovascular functions and the onset of adverse cardiovascular events are influenced by the circadian rhythm that exists in all cell types. In this Review, the authors summarize the role of the molecular clock in cardiovascular physiology and disease and suggest how circadian rhythms can be exploited, such as in chronotherapy, or targeted therapeutically.

Circadian rhythms and the molecular clock in cardiovascular biology and disease