Chronotherapy Advances in the Management of Chronic Neurological and Cardiovascular Diseases: Complex Interactions of Circadian Rhythm Environmental Inputs, Nutrition and Drug Administration and Their Impact on Human Health

Abstract

New scientific evidence raises awareness concerning the human-specific interplay among primary environmental conditions, such as the light–dark cycle, activity–rest alternation, nutritional patterns, and their reflection on the physiological and pathological characteristics that are displayed uniquely by every individual. One of the critical aspects in the clinic is to understand the role of circadian rhythms as remarkable modulators of the biological effects of drugs and to aim for an optimal overlapping of the time of administration of medicines with the physiologic release of certain hormones, the time-dependent expression of genes, or the key-regulatory protein synthesis, which are all circadian-driven processes. The pharmacokinetics and pharmacodynamics profiles, as well as the possible drug interactions of neurotropic and cardiovascular agents, are intensely subjected to endogenous circadian rhythms, being essential to identify as much as possible the patients’ multiple risk factors, from age and gender to lifestyle elements imprinted by dietary features, sleep patterns, psychological stress, all the way to various other associated pathological conditions and their own genetic and epigenetic background. This review chapter will highlight the involvement of biological rhythms in physiologic processes and their impact on various pathological mechanisms, and will focus on the nutritional impact on the circadian homeostasis of the organism and neurologic and cardiovascular chronotherapy.

Sirtuins and Melatonin: Linking Chronobiology to Inflammation and Aging

“…The imbalance of melatonin, which is one of the master regulators of the internal clocks in humans, is clearly associated with an increased risk of diseases, correlated with impaired sleep and aging-associated pathology, mainly cardiovascular, metabolic, and neurodegenerative disease [35][36][37][38][39][40][41][42].…”

“…These results confirm the observations regarding the higher incidence rate of cardiovascular events (myocardial infarction, stroke, arrhythmias, and sudden cardiac deaths) in the morning than in the evening. Also, from a chronotherapeutic perspective, the efficacy of antihypertensive treatments is higher when administered in the afternoon, according to both animal and human studies [41,[79][80][81].…”

Circadian Rhythms, Chrononutrition, Physical Training, and Redox Homeostasis—Molecular Mechanisms in Human Health

“…This compromise is evident at both the cellular and organism levels, and it can precipitate a cascade of adverse consequences. Among these consequences are the emergence and progression of various diseases, including but not limited to cardiovascular syndromes, neurodegenerative disorders, and cancer [4,10,56,[123][124][125][126][127].…”

“…Scientific studies have firmly established the indispensable role of the circadian system in orchestrating key biological processes, encompassing crucial aspects such as homeostasis, cardiovascular regulation, and glucose metabolism. Disruptions to the circadian clock, characterized by disturbances or the loss of rhythmicity, have emerged as prominent contributors to the development of various diseases and premature aging, consequently justifying recognition as significant health-related concerns [1][2][3][4][5][6][7].…”

Intermittent Fasting on Human Health and Disease

“…In the framework of changes in dietary patterns, there are two main approaches: either a reductive shift of the caloric intake/change in food quality or an important modification of feeding behaviour in regard to the timeline of eating. Regarding food composition, research shows that enriching human diet in polyunsaturated fatty acids as well as natural antioxidants leads to an improvement of cardio-metabolic risk [3,6,[11][12][13][14][15][16][17][18][19].…”