Chronobiology and Cardiovascular Disease: Circadian Disruption as a modificable risk factor in Heart Failure and Acute Coronary Syndroms

Abstract Circadian rhythms, governed by the suprachiasmatic nucleus and peripheral clocks, regulate critical physiological processes, including cardiovascular function. Disruptions to these rhythms—through shift work, sleep disorders, or lifestyle factors—are increasingly recognized as modifiable risk factors for cardiovascular diseases (CVD), particularly heart failure (HF) and acute coronary syndromes (ACS). This review synthesizes current evidence on the mechanistic links between circadian disruption and CVD, highlighting molecular pathways, clinical implications, and potential interventions. We discuss how circadian misalignment affects endothelial function, autonomic balance, and metabolic regulation, contributing to disease progression. Strategies to restore circadian alignment, such as chronotherapy and lifestyle modifications, are evaluated for their efficacy in reducing cardiovascular risk. This article underscores the need for integrating chronobiological principles into clinical practice to improve outcomes in HF and ACS.