Circadian Rhythm, Clock Genes, and Hypertension: Recent Advances in Hypertension

Hypertension. 2021 Nov;78(5):1185-1196. doi: 10.1161/HYPERTENSIONAHA.121.14519. Epub 2021 Oct 4.


Accumulating evidence suggests that the molecular circadian clock is crucial in blood pressure (BP) control. Circadian rhythms are controlled by the central clock, which resides in the suprachiasmatic nucleus of the hypothalamus and peripheral clocks throughout the body. Both light and food cues entrain these clocks but whether these cues are important for the circadian rhythm of BP is a growing area of interest. The peripheral clocks in the smooth muscle, perivascular adipose tissue, liver, adrenal gland, and kidney have been recently implicated in the regulation of BP rhythm. Dysregulation of the circadian rhythm of BP is associated with adverse cardiorenal outcomes and increased risk of cardiovascular mortality. In this review, we summarize the most recent advances in peripheral clocks as BP regulators, highlight the adverse outcomes of disrupted circadian BP rhythm in hypertension, and provide insight into potential future work in areas exploring the circadian clock in BP control and chronotherapy. A better understanding of peripheral clock function in regulating the circadian rhythm of BP will help pave the way for targeted therapeutics in the treatment of circadian BP dysregulation and hypertension.

Keywords: blood pressure; circadian rhythm; kidney diseases; suprachiasmatic nucleus; therapeutics.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure / drug effects
  • Blood Pressure / genetics
  • Blood Pressure / physiology*
  • CLOCK Proteins / genetics
  • CLOCK Proteins / metabolism*
  • Circadian Clocks / genetics
  • Circadian Clocks / physiology*
  • Circadian Rhythm / physiology*
  • Clinical Trials as Topic
  • Gene Expression Regulation / drug effects
  • Humans
  • Hypertension / drug therapy
  • Hypertension / genetics
  • Hypertension / physiopathology*


  • Antihypertensive Agents
  • CLOCK Proteins