Appropriate Circadian-Circasemidian Coupling Protects Blood Pressure from Morning Surge and Promotes Human Resilience and Wellbeing

Kuniaki Otsuka, Shougo Murakami, Kiyotaka Okajima, Koichi Shibata, Yutaka Kubo, Denis G. Gubin, Larry A. Beaty, Germaine Cornelissen

Research output: Contribution to journalReview articlepeer-review


Background: Blood pressure (BP) variability is involved in the appraisal of threat and safety, and can serve as a potential marker of psychological resilience against stress. The relationship between biological rhythms of BP and resilience was cross-sectionally assessed by 7-day/24-hour chronobiologic screening in a rural Japanese community (Tosa), with focus on the 12-hour component and the “circadian-circasemidian coupling” of systolic (S) BP. Subjects and Methods: Tosa residents (N = 239, 147 women, 23–74 years), free of anti-hypertensive medication, completed 7-day/ 24-hour ambulatory BP monitoring. The circadian-circasemidian coupling was determined individually by computing the difference between the circadian phase and the circasemidian morning-phase of SBP. Participants were classified into three groups: those with a short coupling interval of about 4.5 hours (Group A), those with an intermediate coupling interval of about 6.0 hours (Group B), and those with a long coupling interval of about 8.0 hours (Group C). Results: Residents of Group B who showed optimal circadian-circasemidian coordination had less pronounced morning and evening SBP surges, as compared to residents of Group A (10.82 vs 14.29 mmHg, P < 0.0001) and Group C (11.86 vs 15.21 mmHg, P < 0.0001), respectively. The incidence of morning or evening SBP surge was less in Group B than in Group A (P < 0.0001) or Group C (P < 0.0001). Group B residents showed highest measures of wellbeing and psychological resilience, assessed by good relation with friends (P < 0.05), life satisfaction (P < 0.05), and subjective happiness (P < 0.05). A disturbed circadian-circasemidian coupling was associated with elevated BP, dyslipidemia, arteriosclerosis and a depressive mood. Conclusion: The circadian-circasemidian coupling of SBP could serve as a new biomarker in clinical practice to guide precision medicine interventions aimed at achieving properly timed rhythms, and thereby resilience and wellbeing.

Original languageEnglish (US)
Pages (from-to)755-769
Number of pages15
JournalClinical interventions in aging
StatePublished - May 2023

Bibliographical note

Publisher Copyright:
© 2023 Otsuka et al.


  • 12-hour morning acrophase
  • 7-day/24-hour chronobiologic screening
  • appropriate circadian-circasemidian coupling
  • biological 12-hour rhythm
  • blood pressure
  • circadian acrophase
  • evening blood pressure surge
  • human resilience
  • morning blood pressure surge
  • wellbeing

PubMed: MeSH publication types

  • Journal Article


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