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Circadian misalignment increases cardiovascular disease risk factors in humans
Open accessAbstract
Significance: Shift work is a risk factor for hypertension, inflammation, and cardiovascular disease, even after controlling for traditional risk factors. Shift workers frequently undergo circadian misalignment (i.e., misalignment between the endogenous circadian system and 24-h environmental/behavioral cycles). This misalignment has been proposed to explain, in part, why shift work is a risk factor for hypertension, inflammation, and cardiovascular disease. However, the impact of circadian misalignment per se on 24-h blood pressure and inflammatory markers is poorly understood. We show—under highly controlled laboratory conditions—that short-term circadian misalignment increases 24-h blood pressure and inflammatory markers in healthy adults. Our findings may help explain why shift work increases hypertension, inflammation, and cardiovascular disease risk.
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“A recent laboratory study of shift workers revealed that circadian misalignment increased 24-hour BP and CV inflammatory markers including IL-6, C-reactive protein, and TNF-α (142).”
From Role of the circadian system in cardiovascular disease (2018) · cites this paper as [142]
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Chellappa, S. L., Engen, P. A., Naqib, A. D., Qian, J., Vujović, N., Rahman, N., Green, S. J., Garaulet, M., Keshavarzian, A., & Scheer, F. A. J. L. (2022) · Kölner Universitäts PublikationsServer (Universität zu Köln) · Cited by 18
Self-citationThe Effect of Light on Wellbeing: A Systematic Review and Meta-analysis
Landvreugd, A., Nivard, M. G., & Bartels, M. (2024) · Journal of Happiness Studies · doi:10.1007/s10902-024-00838-4 · Cited by 21
“For example, Morris et al., (2016) conducted a randomized controlled trial and found that circadian misalignment contributes to cardiovascular risk factors, such as blood pressure and vagal activity.”
Forshaw, P. E., Correia, A. T. L., Roden, L. C., Lambert, E. V., & Rae, D. E. (2022) · Blood Pressure Monitoring · doi:10.1097/mbp.0000000000000619 · Cited by 19
Circadian Mechanisms in Cardiovascular and Cerebrovascular Disease
Lo, E. H., & Faraci, F. M. (2024) · Circulation Research · doi:10.1161/circresaha.124.324462 · Cited by 17
Reutrakul, S., Sumritsopak, R., Saetung, S., Chanprasertyothin, S., Chailurkit, L., & Anothaisintawee, T. (2017) · Neurobiology of Sleep and Circadian Rhythms · doi:10.1016/j.nbscr.2017.06.001 · Cited by 17
“Wright et al., 2015; Morris et al., 2015; Morris et al., 2016).”
Jing, J.-N., Wu, Z.-T., Li, M., Wang, Y., Tan, X. L., & Wang, W. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.00248 · Cited by 17
The Importance of Keeping Time in the Liver
McCommis, K. S., & Butler, A. A. (2020) · Endocrinology · doi:10.1210/endocr/bqaa230 · Cited by 19
Rapid changes in overnight blood pressure after transitioning to early-morning shiftwork
McHill, A. W., Velasco, J., Bodner, T., Shea, S. A., & Olson, R. (2021) · SLEEP · doi:10.1093/sleep/zsab203 · Cited by 18
Cold-Induced Thermogenesis Shows a Diurnal Variation That Unfolds Differently in Males and Females
Straat, M. E., Martínez‐Téllez, B., Mishre, A. S. D. S., Verkleij, M. M. A., Kemmeren, M., Pelsma, I. C. M., Alcántara, J. M. A., Méndez-Gutiérrez, A., Kooijman, S., Boon, M. R., et al. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac094 · Cited by 17
The impact of night-shift work on platelet function in healthy medical staff
Nakao, T., Yasumoto, A., Tokuoka, S. M., Kita, Y., Kawahara, T., Daimon, M., & Yatomi, Y. (2018) · Journal of Occupational Health · doi:10.1539/joh.2018-0027-fs · Cited by 17
Li, Y., Lu, L., & Androulakis, I. P. (2024) · Journal of Pharmaceutical Sciences · doi:10.1016/j.xphs.2023.08.005 · Cited by 17
Nuclear Receptors and Clock Components in Cardiovascular Diseases
Pourcet, B., & Duez, H. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22189721 · Cited by 19
Makris, K. C., Heibati, B., & Narui, S. Z. (2023) · Environment International · doi:10.1016/j.envint.2023.108048 · Cited by 16
“…the central circadian pacemaker and the 24-h environmental and behavioral cycles, a randomized cross-over trial suggested that short-term circadian misalignment increased 24-h blood pressure and inflammatory markers of CRP, TNF-α , resistin, and IL-6 in healthy adults (n = 14) (Morris et al. 2016).”
Current perspective on circadian function of the kidney
Benjamin, J. I., & Pollock, D. M. (2023) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00247.2023 · Cited by 18
Effects of Half- or Whole-Night Shifts on Physiological and Cognitive Parameters in Women
Çakan, P., & Yıldız, S. (2019) · The American Journal of the Medical Sciences · doi:10.1016/j.amjms.2019.12.002 · Cited by 17
Hernandez-Garcia, E., Chrysikou, E. G., & Kalea, A. Z. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182010891 · Cited by 16
Thakur, A., & Kishore, R. (2025) · Neurobiology of Sleep and Circadian Rhythms · doi:10.1016/j.nbscr.2025.100131 · Cited by 19
Zhao, B., Li, J., Feng, D., Liu, J., Hao, Y., Zhen, Y., Hao, X., Liu, F., Zuo, A., Yang, X., et al. (2020) · Journal of Hypertension · doi:10.1097/hjh.0000000000002755 · Cited by 15
“Considering the abnormal circadian rhythm caused by night shift might play a significant role in the increase of hypertension risk [22,23], it may be supposed that permanent night workers were less likely to be hypertensive as they would gradually adapt to night shift in circadian rhythms.”
BackgroundHe, X., Yang, S., Deng, J., Wu, Q., & Zang, W. (2021) · Laboratory Investigation · doi:10.1038/s41374-021-00578-6 · Cited by 16
Delisle, B. P., George, A. L., Nerbonne, J. M., Bass, J. T., Ripplinger, C. M., Jain, M. K., Hermanstyne, T. O., Young, M. E., Kannankeril, P. J., Duffy, J. F., et al. (2021) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.121.010190 · Cited by 16
Self-citationHealthy Sleep Every Day Keeps the Doctor Away
Feingold, C. L., & Smiley, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191710740 · Cited by 19
Yeung, C. H. C., Bauer, C., & Xiao, Q. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13854 · Cited by 15
“Previous research showed a weakened circadian rhythm caused by circadian misalignment in shift workers is frequently accompanied by a lower 24-h mean melatonin level and a delayed melatonin rhythm (Gumenyuk et al., 2012; Morris et al., 2016).”
BackgroundZhou, W., Sun, L., Zeng, L., & Wan, L. (2023) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2023.102183 · Cited by 16
The Role of Circadian Rhythm in Neurological Diseases: A Translational Perspective
Huang, W., Zong, J., Zhang, Y. L., Zhou, Y., Zhang, L., Wang, Y., Shan, Z., Xie, Q., Li, M., Pan, S., et al. (2023) · Aging and Disease · doi:10.14336/ad.2023.0921 · Cited by 16
Nighttime administration of antihypertensive medication: a review of chronotherapy in hypertension
Kim, H., & Jo, S. (2023) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2023.304 · Cited by 15
“This can result in poor sleep quality, reduced cognitive function, and a greater risk for various health problems, including CVDs, increased 24 hours blood pressure and blood pressure during sleep, and reduced blood pressure dipping during sleep [50-52].”
BackgroundShifts in the light-dark cycle increase unpredictability of the cardiovascular system
Molčan, Ľ., & Zeman, M. (2017) · Autonomic Neuroscience · doi:10.1016/j.autneu.2017.07.006 · Cited by 15
Metadata
- Authors
- Morris, C. J., Purvis, T. E., Hu, K., & Scheer, F. A. J. L.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2016-02-08
- Volume
- 113
- Issue
- 10
- Pages
- E1402-11
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC4790999
- OpenAlex
- W2259214365
- Cited by
- 691
- References
- 81
- Citations by year
- 2026: 82 · 2025: 84 · 2024: 69 · 2023: 87 · 2022: 82 · 2021: 74 · 2020: 64 · 2019: 49 · 2018: 43 · 2017: 45 · 2016: 10
- FWCI
- 69.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Aeronautics and Space Administration (NCC958)
- Brigham and Women's Hospital (UL1RR025758)
- Harvard University (UL1RR025758)
- National Space Biomedical Research Institute (P01 AG009975, NCC 9‐58)
- National Institute on Aging (R01AG048108, P01AG009975)
- National Heart, Lung, and Blood Institute (R00HL102241, R01HL118601, R01HL094806)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK099512, DK099512)
- National Center for Research Resources (UL1RR025758)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- circadian misalignment, shift work, cardiovascular risk, hypertension, blood pressure, sleep blood pressure, cardiac vagal modulation, heart rate variability, urinary epinephrine, urinary norepinephrine, inflammation, interleukin-6, C-reactive protein, resistin, TNF-α
- MeSH terms
- Adult, Blood Pressure, C-Reactive Protein, Cardiovascular Diseases, Circadian Rhythm, Epinephrine, Female, Heart Rate, Humans, Hypertension, Male, Middle Aged, Risk Factors, Time Factors, Tumor Necrosis Factor-alpha, Work Schedule Tolerance, Interleukin-6, Polysomnography, Cross-Over Studies, Sleep Disorders, Circadian Rhythm, Resistin, Young Adult, Actigraphy
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