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Cholinergic stimulation with pyridostigmine blunts the cardiac responses to mental stress
A C Nóbrega1, A C Carvalho, K B Santos
1Department of Physiology, Universidade Federal Fluminense, Niterói, RJ, Brazil. anobrega@web4u.com.br
Insights
Pyridostigmine bromide (PYR) blunted cardiac responses to mental stress in healthy subjects. This cholinesterase inhibitor reduced heart rate, blood pressure, and rate-pressure product during stress challenges.
Area of Science:
- Cardiology
- Pharmacology
- Neuroscience
Background:
- Mental stress can trigger myocardial ischemia and ventricular arrhythmias in coronary artery disease patients.
- Cholinergic stimulation may offer cardioprotection against stress-induced cardiac events.
Purpose of the Study:
- To investigate the effect of pyridostigmine bromide (PYR), a reversible cholinesterase inhibitor, on cardiac responses during a mental stress test.
- To assess PYR's potential to mitigate cardiovascular strain induced by psychological stress.
Main Methods:
- A randomized, crossover, double-blind study involving 12 healthy volunteers.
- Participants underwent a mental stress test (arithmetic task) 2 hours after ingesting either 45 mg of PYR or a placebo on separate occasions.
- Cardiac parameters including heart rate, blood pressure, and rate-pressure product were monitored.
Main Results:
- Pyridostigmine bromide (PYR) significantly reduced heart rate, peak systolic pressure, peak diastolic pressure, and mean rate-pressure product compared to placebo during mental stress.
- The mean RR interval was prolonged with PYR administration.
- PYR attenuated the pressor and chronotropic responses to the mental stress challenge.
Conclusions:
- A 45 mg dose of pyridostigmine bromide effectively blunted the cardiovascular responses to mental stress in healthy young adults.
- These findings suggest a potential role for cholinesterase inhibitors in managing stress-induced cardiovascular strain.
Abstract:
Mental stress may induce myocardial ischemia and ventricular arrhythmia in patients with coronary artery disease, and cholinergic stimulation is a potential protective mechanism. The purpose of this study was to determine the effect of pyridostigmine bromide (PYR), a reversible cholinesterase inhibitor, on the cardiac responses to a mental stress challenge. Twelve healthy young volunteers were submitted to a mental stress test (arithmetic test) 2 hours after the oral administration of either placebo or PYR (45 mg) on two separate days, following a randomized crossover double-blind protocol. Heart rate was reduced after both placebo and PYR (p < 0.05), but the cardiac responses to the mental stress were lower with PYR (p < 0.05): mean RR interval (mean +/- SE)-placebo: 730 +/- 19 msec; PYR: 769 +/- 21 msec; Peak systolic pressure-placebo: 129 +/- 4 mmHg; PYR: 124 +/- 3 mmHg; Peak diastolic pressure-placebo: 92 +/- 3 mmHg; PYR: 89 +/- 4 mmHg; Mean rate-pressure product-placebo: 10,496 +/- 412 bpm x mmHg; PYR: 9,746 +/- 383 bpm x mmHg. In conclusion, 45 mg of pyridostigmine blunted the pressor and chronotropic responses to mental stress in healthy young subjects.