Toward Precision Medicine: Circadian Rhythm of Blood Pressure and Chronotherapy for Hypertension - 2021 NHLBI Workshop Report

Michelle L. Gumz, Daichi Shimbo, Marwah Abdalla, Ravi C. Balijepalli, Christian Benedict, Yabing Chen, David J. Earnest, Karen L. Gamble, Scott R. Garrison, Ming C. Gong, John B. Hogenesch, Yuling Hong, Jessica R. Ivy, Bina Joe, Aaron D. Laposky, Mingyu Liang, Eric J. Maclaughlin, Tami A. Martino, David M. Pollock, Susan RedlineAmy Rogers, R. Dan Rudic, Eva S. Schernhammer, George S. Stergiou, Marie Pierre St-Onge, Xiaoling Wang, Jacqueline Wright, Young S. Oh

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations


Healthy individuals exhibit blood pressure variation over a 24-hour period with higher blood pressure during wakefulness and lower blood pressure during sleep. Loss or disruption of the blood pressure circadian rhythm has been linked to adverse health outcomes, for example, cardiovascular disease, dementia, and chronic kidney disease. However, the current diagnostic and therapeutic approaches lack sufficient attention to the circadian rhythmicity of blood pressure. Sleep patterns, hormone release, eating habits, digestion, body temperature, renal and cardiovascular function, and other important host functions as well as gut microbiota exhibit circadian rhythms, and influence circadian rhythms of blood pressure. Potential benefits of nonpharmacologic interventions such as meal timing, and pharmacologic chronotherapeutic interventions, such as the bedtime administration of antihypertensive medications, have recently been suggested in some studies. However, the mechanisms underlying circadian rhythm-mediated blood pressure regulation and the efficacy of chronotherapy in hypertension remain unclear. This review summarizes the results of the National Heart, Lung, and Blood Institute workshop convened on October 27 to 29, 2021 to assess knowledge gaps and research opportunities in the study of circadian rhythm of blood pressure and chronotherapy for hypertension.

Original languageEnglish
Pages (from-to)503-522
Number of pages20
Issue number3
StatePublished - Mar 1 2023

Bibliographical note

Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.


  • circadian clock
  • kidney
  • microbiota
  • sleep
  • vasculature

ASJC Scopus subject areas

  • Internal Medicine


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