Circadian Rhythms, Metabolic Disorders, and Cardiovascular Aging: Molecular Crosstalk and Clinical Translation.

Abstract

Circadian rhythms play a crucial role in regulating physiological processes, and disruptions caused by aging, shift work, or irregular schedules are closely associated with metabolic dysfunction and accelerated cardiovascular aging. Age-related declines in circadian clock function contribute to metabolic imbalances and cardiovascular decline through pathways involving inflammation, oxidative stress, and mitochondrial dysfunction. Research has identified complex molecular networks linking circadian dysregulation to metabolic disorders and cardiovascular diseases, highlighting potential therapeutic targets such as sirtuin 1, peroxisome proliferator-activated receptor α, and reverse erythroblastosis virus α. Interventions based on circadian principles-such as time-restricted eating, chronotherapy, lifestyle modifications, and light therapy-exhibit promise in mitigating cardiovascular aging. However, several of these strategies require further validation in older adults, and challenges persist in clinical implementation owing to a lack of large-scale trials, population diversity, and real-world barriers. This review synthesizes current mechanistic evidence and underscores the necessity for personalized circadian-based approaches to enhance cardiovascular health in aging populations.