Abstract
Blood pressure (BP) follows a circadian rhythm, it increases on waking in the morning and decreases during sleeping at night. Disruption of the circadian BP rhythm has been reported to be associated with worsened cardiovascular and renal outcomes, however the underlying molecular mechanisms are still not clear. In this review, we briefly summarized the current understanding of the circadian BP regulation and provided therapeutic overview of the relationship between circadian BP rhythm and cardiovascular and renal health and disease.
Highlights
Introduction of Circadian Blood pressure (BP) RhythmCircadian rhythm refers to an endogenous biorhythm with a 24 h cycle driven by an intrinsic and periodic molecular clock that adjusts behavior and physiological activities to external environmental changes [1,2]
The master pacemaker located in the suprachiasmatic nucleus (SCN) of the hypothalamus elaborately controls the peripheral clocks in other tissues to ensure the synchronization of all existing clocks [3,4]
In accordance with altered BP pattern, the clock gene Per1 might regulate the transcription of epithelial sodium channel (ENaC), sodium-glucose linked transporter-1 (SGLT-1), sodium-hydrogen exchanger-3 (NHE3), endothelin-1 (ET-1), which are responsible for sodium transport in the kidney [43,60,61]
Summary
Circadian rhythm refers to an endogenous biorhythm with a 24 h cycle driven by an intrinsic and periodic molecular clock that adjusts behavior and physiological activities to external environmental changes [1,2]. Nuclear receptors ROR (RAR-related orphan receptor) activates and REV-ERB (nuclear receptor subfamily 1, group D) suppresses RORE (ROR element) to directly control Bmal and Clock transcription [8]. Another nuclear receptor PPARγ integrated in this loop is a target gene of BMAL1 by directly binding to PPRE (PPAR response element) in its promoter [9]. The rhythm of BP can be affected by temperature, noise and many other environmental factors [36,37,38]
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