Understanding the mechanistic interlink between circadian misalignment and heart disease in night shift workers: Therapeutic role of behavioral interventions.

Background: Rotating and night shift work, especially in older workers, is a growing health concern of modern societies due to the associated high morbidity and mortality rates from cardiovascular disease (CVD). The resulting circadian misalignment disrupts neuroendocrine pathways that regulate cardiovascular physiology, risking myocardial tissue damage and heart dysfunction.

Aims: Considering the gaps in the literature as to how atypical work behaviors may disrupt the temporal link between the central and myocardial oscillators at the level of the proteome and transcriptome, the primary goal of this review is to assess the molecular mechanisms linking disrupted biological rhythms to heart health, with a focus on core clock genes like BMAL1 and cardiac troponin I (cTnI) as a myocardial biomarker.

Major findings: Circadian misalignment can lead to cognitive decline, metabolic dysfunction, and immune disruption, all of which elevate CVD risk. BMAL1 has a key role in maintaining cardiovascular integrity, with its dysfunction associated with hypertension, arrhythmias, and myocardial injury. Additionally, disrupted sleep patterns influence the expression of clock genes, potentially leading to altered heart function and elevated levels of cardiac biomarkers like troponin.

Conclusion: Circadian misalignment poses significant CVD risks, particularly for older workers. Future research should investigate how the expression of central and peripheral clock genes, as well as cardiac biomarkers is affected by shift work, especially in older individuals. Behavioral interventions such as chronotherapy, light therapy, and scheduled evening sleep may help mitigate these risks, but more studies are needed to assess their long-term effectiveness.