Existence of an Endogenous Circadian Blood Pressure Rhythm in Humans That Peaks in the Evening
Open accessAbstract
Rationale: Blood pressure (BP) usually decreases during nocturnal sleep and increases during daytime activities. Whether the endogenous circadian control system contributes to this daily BP variation has not been determined under appropriately controlled conditions. Objective: To determine whether there exists an endogenous circadian rhythm of BP in humans. Methods and Results: In 28 normotensive adults (16 men), we assessed BP across 3 complementary, multiday, in-laboratory protocols performed in dim light, throughout which behavioral and environmental influences were controlled and/or uniformly distributed across the circadian cycle via: (1) a 38-hour “constant routine,” including continuous wakefulness; (2) a 196-hour “forced desynchrony” with 7 recurring 28-hour sleep/wake cycles; and (3) a 240-hour forced desynchrony with 12 recurring 20-hour sleep/wake cycles. Circadian phases were derived from core body temperature. Each protocol revealed significant circadian rhythms in systolic and diastolic BP, with almost identical rhythm profiles among protocols. The peak-to-trough amplitudes were 3 to 6 mm Hg for systolic BP and 2 to 3 mm Hg for diastolic BP (always P <0.05). All 6 peaks (systolic and diastolic BP in 3 protocols) occurred at a circadian phase corresponding to ≈9:00 pm (ie, the biological evening). Based on substantial phase differences among circadian rhythms of BP and other variables, the rhythm in BP appeared to be unrelated to circadian rhythms in cortisol, catecholamines, cardiac vagal modulation, heart rate, or urine flow. Conclusions: There exists a robust endogenous circadian rhythm in BP. The highest BP occurred at the circadian time corresponding to ≈9:00 pm , suggesting that the endogenous BP rhythm is unlikely to underlie the well-documented morning peak in adverse cardiovascular events.
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Using three stringently controlled constant routine and forced desynchrony protocols that overcame limitations of earlier studies, robust endogenous circadian rhythms in blood pressure were discovered.
“In contrast, using three stringently controlled constant routine and forced desynchrony protocols that overcame these limitations, robust endogenous circadian rhythms in BP were discovered (83,90).”
From Role of the circadian system in cardiovascular disease (2018) · cites this paper as [83]
The authors demonstrated a robust endogenous circadian rhythm in blood pressure in healthy humans, with very similar timing and amplitude across three different protocols.
“recently, we demonstrated a robust endogenous circadian rhythm in blood pressure in healthy humans, with very similar timing and amplitude across three different protocols”
From The impact of the circadian timing system on cardiovascular and metabolic function (2012) · cites this paper as Shea et al., 2011
The lack of a circadian rhythm in blood pressure in previous studies was likely related to methodological limitations including lighting control, posture, and circadian phase assessment.
“The lack of a circadian rhythm in blood pressure in previous studies was likely related to methodological limitations, including lighting control, posture, and circadian phase assessment”
From The impact of the circadian timing system on cardiovascular and metabolic function (2012) · cites this paper as Shea et al., 2011
In humans, resting plasma epinephrine and norepinephrine levels exhibit endogenous circadian rhythmicity with a broad peak during the middle of the biological day.
“In humans, resting plasma epinephrine and norepinephrine levels—markers of sympathetic nervous activity—exhibit endogenous circadian rhythmicity with a broad peak during the middle of the biological day”
From The impact of the circadian timing system on cardiovascular and metabolic function (2012) · cites this paper as Shea et al., 2011
The circadian peak in blood pressure occurred during the biological evening, corresponding to approximately 9 PM.
“The circadian peak in blood pressure occurred during the biological evening, corresponding to approximately 9 PM.”
From The impact of the circadian timing system on cardiovascular and metabolic function (2012) · cites this paper as Shea et al., 2011
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- Authors
- Shea, S. A., Hilton, M. F., Hu, K., & Scheer, F. A. J. L.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Circulation Research
- Published
- 2011-04-15
- Volume
- 108
- Issue
- 8
- Pages
- 980-984
- ISSN
- 0009-7330 (ISSN-L)
- 1524-4571
- PMC
- PMC3086568
- OpenAlex
- W2163177724
- Cited by
- 179
- References
- 16
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 11 · 2023: 16 · 2022: 21 · 2021: 15 · 2020: 15 · 2019: 16 · 2018: 5 · 2017: 17 · 2016: 3 · 2015: 6 · 2014: 10 · 2013: 14 · 2012: 10
- FWCI
- 5.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (K24-HL76446, K24HL076446, R01HL076409, R01HL064815, P30HL101299, R01 HL64815)
- National Center for Research Resources (M01 RR 02635, UL1RR025758, M01RR002635)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- circadian rhythm, blood pressure, constant routine, forced desynchrony, sleep-wake cycle, core body temperature, circadian phase, cardiovascular events, normotensive subjects
- MeSH terms
- Adult, Blood Pressure, Cardiovascular Diseases, Circadian Rhythm, Female, Humans, Male, Time Factors, Blood Pressure Monitoring, Ambulatory, Young Adult
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