Pressure Building Against the Clock: The Impact of Circadian Misalignment on Blood Pressure.

IF 3.9 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Current Hypertension Reports Pub Date : 2024-01-01 Epub Date: 2023-10-14 DOI:10.1007/s11906-023-01274-0
Brooke M Shafer, Sophia A Kogan, Andrew W McHill
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Abstract

Purpose of review: Misalignment between the endogenous biological timing system and behavioral activities (i.e., sleep/wake, eating, activity) contributes to adverse cardiovascular health. In this review, we discuss the effects of recurring circadian misalignment on blood pressure regulation and the implications for hypertension development. Additionally, we highlight emerging therapeutic approaches designed to mitigate the negative cardiovascular consequences elicited by circadian disruption.

Recent findings: Circadian misalignment elicited by work schedules that require individuals to be awake during the biological night (i.e., shift work) alters 24-h blood pressure rhythms. Mechanistically, circadian misalignment appears to alter blood pressure via changes in autonomic nervous system balance, variations to sodium retention, dysregulation of endothelial vasodilatory responsiveness, and activation of proinflammatory mechanisms. Recurring circadian misalignment produced by a mismatch in sleep timing on free days vs. work days (i.e., social jetlag) appears to have no direct effects on prevailing blood pressure levels in healthy adults; though, circadian disruptions resulting from social jetlag may increase the risk of hypertension through enhanced sympathetic activation and/or obesity. Furthermore, social jetlag assessment may be a useful metric in shift work populations where the magnitude of circadian misalignment may be greater than in the general population. Circadian misalignment promotes unfavorable changes to 24-h blood pressure rhythms, most notably in shift working populations. While light therapy, melatonin supplementation, and the timing of drug administration may improve cardiovascular outcomes, interventions designed to target the effects of circadian misalignment on blood pressure regulation are warranted.

Abstract Image

昼夜节律失调对血压的影响。
综述目的:内源性生物时间系统与行为活动(即睡眠/觉醒、饮食、活动)之间的不一致会导致不良的心血管健康。在这篇综述中,我们讨论了反复出现的昼夜节律失调对血压调节的影响以及对高血压发展的影响。此外,我们强调了旨在减轻昼夜节律紊乱引起的负面心血管后果的新兴治疗方法。最近的研究结果:工作时间表要求个人在生物之夜(即轮班工作)保持清醒,从而导致昼夜节律失调,从而改变24小时的血压节律。从机制上讲,昼夜节律失调似乎通过自主神经系统平衡的变化、钠潴留的变化、内皮血管舒张反应性的失调和促炎机制的激活来改变血压。自由日与工作日的睡眠时间不匹配(即社交时差)导致的昼夜节律失调似乎对健康成年人的主要血压水平没有直接影响;然而,社交时差导致的昼夜节律紊乱可能会通过增强交感神经激活和/或肥胖来增加患高血压的风险。此外,在轮班工作人群中,社会时差评估可能是一个有用的指标,因为轮班工作人群的昼夜节律失调程度可能比普通人群更大。昼夜节律失调会导致24小时血压节律发生不利变化,尤其是在轮班工作人群中。虽然光疗、补充褪黑激素和给药时间可能会改善心血管结果,但有必要针对昼夜节律失调对血压调节的影响进行干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Hypertension Reports
Current Hypertension Reports 医学-外周血管病
CiteScore
10.50
自引率
0.00%
发文量
65
审稿时长
6-12 weeks
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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