Autonomic Nervous System as a Target for Cardiovascular Drugs

Abstract

1. Drugs acting within the autonomic nervous system (ANS) are of particular interest when autonomic abnormalities are implicated in the development and maintenance of various cardiovascular pathologies. For example, it has been documented that in the early stages of hypertensive disease (i.e. hyperkinetic borderline hypertension) a sympathetic hyperactivity associated with a decreased parasympathetic activity results in increased cardiac output and heart rate. 2. Several classes of drugs acting within the central, as well as the peripheral ANS, are very efficient in treating hypertensive disease. One of these classes of drugs, the second generation of centrally acting drugs, has proved beneficial in this respect because, in addition to their therapeutic efficacy, these drugs are well tolerated. 3. The central nervous system may also be the target for drugs with the potential to treat other cardiovascular diseases. Some recent experimental and clinical data supporting such new perspectives concerning idiopathic dysrhythmias, angina pectoris and congestive heart failure will be summarized.

Frequency, risk factors, and impacts on quality of life of the restless legs syndrome and side effects among antidepressant users in a tertiary hospital: an observational cross-sectional study

“…Another finding in this study was the lower reporting of autonomic side effects among antipsychotics or calcium channel blockers users in patients with treated SSRI/SNRI. The different classes of drugs may interfere with sympathetic activation (Bousquet et al ., 1998; Curtis and O’Keefe, 2002; Iwamoto et al , 2012; Lotufo et al , 2012; Miyauchi et al , 2016; Grassi et al ., 2020). But, autonomic nervous system activity disturbances would increase the risk of cardiovascular events.…”

Heart rate variability in the evaluation of the autonomic nervous system of premature infants

“…Other research groups have analyzed ANS dysfunctions using HRV in preterm infants in several clinical situations: during the presence of pain (Delane, Bohorquez, Gupta, & Schiavenato, 2016), sepsis (Bohanon et al, 2015), malnutrition (Barreto, Vanderlei, Vanderlei, & Leite, 2016), as well as in the presence of essential hypertension (Yakinci, Müngen, Tayfun, Gündüz, & Karabiber, 1996), migraine (Yakinci, Müngen, Er, Durmaz, & Karabiber, 1999) and hypertonia (Arce-Alvarez et al, 2019), in which children have a dysfunction of the SNS and PNS. There are also studies that investigate therapeutic approaches, such as the influence of cardiovascular medications-several classes of drugs acting within the central, as well as the peripheral, ANS are efficient in treating hypertensive disease (Bousquet, Monassier, & Feldman, 1998); massage, which improves ANS function in infants (Smith et al, 2013); or Kangaroo Care-HRV was reduced during kangaroo care owing to a decrease in the extent of transient heart rate decelerations (Kommers et al, 2017;McCain, Ludington-Hoe, Swinth, & Hadeed, 2005). In premature infants, HRV behavior is less complex compared to that of full-term neonates due to the delay in maturation of autonomic cardiovascular control (Fyfe et al, 2015;Longin, Gerstner, Schaible, Lenz, & König, 2006).…”