Related Experiment Video

Updated: Nov 8, 2025

Optogenetic Activation of Intrinsic Cardiac Autonomic Neurons in Excised Perfused Mouse Hearts
08:29

Optogenetic Activation of Intrinsic Cardiac Autonomic Neurons in Excised Perfused Mouse Hearts

Published on: March 28, 2025

546

Benefits of pharmacological and electrical cholinergic stimulation in hypertension and heart failure

Gisele L Cavalcante1,2, Fernanda Brognara3, Lucas Vaz de C Oliveira1

  • 1Graduate Program in Pharmaceutical Sciences, Department of Biophysics and Physiology, Federal University of Piaui, Teresina, PI, Brazil.

Acta Physiologica (Oxford, England)
|April 22, 2021
PubMed

Insights

Enhancing parasympathetic activity through cholinergic stimulation offers a promising new treatment for hypertension and heart failure. This approach helps restore autonomic balance and improve cardiovascular health.

Area of Science:

  • Cardiovascular Medicine
  • Autonomic Neuroscience
  • Pharmacology

Background:

  • Systemic arterial hypertension and heart failure are prevalent cardiovascular diseases impacting millions globally.
  • These conditions involve an imbalance in the autonomic nervous system, marked by increased sympathetic and decreased parasympathetic activity.
  • Current treatments primarily focus on reducing sympathetic activity, but enhancing parasympathetic function is emerging as a viable therapeutic strategy.

Purpose of the Study:

  • To review experimental and clinical studies on cholinergic stimulation for treating hypertension and heart failure.
  • To explore the potential of enhancing parasympathetic function to correct autonomic and cardiovascular imbalance.
  • To assess the efficacy of acetylcholinesterase inhibitors, baroreflex activation, and vagus nerve stimulation.

Main Methods:

  • Review of published experimental and clinical studies.
  • Analysis of data on cholinergic stimulation, including pharmacological agents and electrical stimulation techniques.
  • Evaluation of effects on autonomic balance, hemodynamics, and baroreflex sensitivity.

Main Results:

  • Acetylcholinesterase inhibitors demonstrate efficacy in improving autonomic imbalance and hemodynamic changes in hypertension and heart failure.
  • Baroreflex activation and vagus nerve stimulation are safe and effective alternative treatments.
  • Cholinergic stimulation effectively counteracts the autonomic dysfunction characteristic of these cardiovascular diseases.

Conclusions:

  • Pharmacological and electrical stimulation of the parasympathetic nervous system show significant potential as therapeutic tools for hypertension and heart failure.
  • These parasympathetic-targeting strategies can help restore autonomic balance and improve cardiovascular outcomes.
  • Further clinical exploration of these approaches is warranted to optimize their application in managing cardiovascular diseases.

Keywords:
anticholinesterasescholinergic stimulationelectrical stimulationparasympathetic nervous systemsympathetic nervous system

More Related Videos

Breathing-controlled Electrical Stimulation BreEStim for Management of Neuropathic Pain and Spasticity11:34

Breathing-controlled Electrical Stimulation BreEStim for Management of Neuropathic Pain and Spasticity

Published on: January 10, 2013

23.4K
Simultaneous Electrical and Mechanical Stimulation to Enhance Cells' Cardiomyogenic Potential07:41

Simultaneous Electrical and Mechanical Stimulation to Enhance Cells' Cardiomyogenic Potential

Published on: January 18, 2019

7.8K

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
647
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
542
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
68
Indirect-Acting Cholinergic Agonists: Pharmacological Actions01:30

Indirect-Acting Cholinergic Agonists: Pharmacological Actions

Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
1.1K
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
154
Direct-Acting Cholinergic Agonists: Pharmacological Actions00:59

Direct-Acting Cholinergic Agonists: Pharmacological Actions

Direct-acting cholinergic agonists exert their pharmacological actions by mimicking the effects of acetylcholine on postsynaptic muscarinic receptors to generate parasympathetic responses. These agents elicit a range of physiological responses, including cardiovascular effects. For example, activation of muscarinic receptors induces bradycardia, decreased cardiac output, reduced peripheral resistance, and consequent hypotension. In the eye, stimulation of M3 receptors leads to smooth muscle...
2.0K