Role of Circadian Health in Cardiometabolic Health and Disease Risk: A Scientific Statement From the American Heart Association

Abstract

Cardiovascular and metabolic health are influenced by the circadian system, which regulates 24-hour rhythms across numerous physiologic processes. Disruptions to circadian rhythmicity can adversely affect cardiometabolic function and health. Given the importance of circadian health to overall human health, this scientific statement provides an overview of the circadian system and key behavioral factors that can synchronize or desynchronize these rhythms, including light exposure, food intake, physical exercise, and sleep timing. We also summarize the literature on associations between circadian health and cardiometabolic health indicators, such as excessive weight, type 2 diabetes (T2D), hypertension, and cardiovascular disease. We discuss strategies to improve circadian health and reduce circadian disruptions, focusing on interventions that target the key synchronizers of circadian rhythms and involve appropriate timing of exposure to these synchronizers. These include morning bright light exposure and avoidance of light at night, as well as appropriately timed sleep, meals, and exercise. Clinicians, researchers, policymakers, and the public should recognize the role of circadian rhythms in maintaining and promoting cardiometabolic health and focus on identifying modifiable behaviors that can improve them.

Keywords: AHA Scientific Statements; cardiovascular diseases; circadian rhythm; diabetes mellitus, type 2; exercise; hypertension.