Circadian clocks and hypertension: genetics and interactions.

Recent advances in molecular genetics of circadian rhythms and hypertension led to the discovery of separate groups of genes implicated in their regulation. Importantly, the identification in both mammals and flies of 6 homologous circadian clock genes strongly indicates that the circadian period is controlled by an evolutionary conserved set of genes. Studies in familial and experimental hypertension reveal that elevated blood pressure is due to mutations in genes implicated in the function of the renin-angiotensin-aldosterone system. A chronobiologic approach to experimental hypertension indicates that hypertension can be associated with selectively inverted circadian rhythm of arterial pressure. Several lines of evidence suggest that the rostral hypothalamus is an area of central integration of the endogenous rhythmic and other regulatory influences that modulate the phase and amplitude of circadian arterial pressure rhythmicity. The combination of advanced molecular genetics and continuous blood pressure monitoring with chronobiologic assessment emerges as a fruitful approach in better understanding the pathogenesis of hypertension.