title: Cholinesterase inhibitors modulate autonomic function in patients with Alzheimer´s disease and mixed dementia.
abstract: Cholinesterase inhibitors (ChEIs), the mainstay treatment for dementia, have systemic actions that can affect cardiovascular and autonomic nervous system (ANS). Thirty-nine patients with Alzheimer´s disease or mixed dementia underwent a comprehensive clinical evaluation, prior to and during ChEIs therapy, including orthostatic challenge, electrocardiogram (EKG) and heart rate variability (HRV) spectral analysis through Holter recordings. ChEIs therapy determined a decrease in supine diastolic blood pressure (BP) and in both diastolic and systolic BP in orthostatic position (79.8 ± 9.0 vs. 76.4 ± 9.3 mmHg, p=0.012; 79.9 ± 11.6 vs. 75.3 ± 9.9, p=0.005 and 144.6 ± 25.8 vs. 137.6 ± 21.1, p=0.020, respectively). Spectral analysis revealed no difference on static HRV components, but, during orthostatic challenge, an increase in LF/HF ratio (2.2±2.4 vs. 4.6±5.9, p=0.011) and a reduction in HF component emerged (1604.3 ± 5610.1 vs. 266.1 ± 525.5, p=0.010). ChEIs showed no influence on EKG parameters or on the occurrence of orthostatic hypotension. Treatment with ChEIs was associated with functional improvement of the ANS behavior and to a decrease in supine DBP and in both orthostatic SBP and DBP.
authors.affiliation: Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto e. filipileles@gmail.com
authors.forename: Filipi Leles
authors.initials: FL
authors.lastname: da Costa Dias
authors.forename: Rose Mary
authors.initials: RM
authors.lastname: Ferreira Lisboa da Silva
authors.forename: Edgar Nunes
authors.initials: EN
authors.lastname: de Moraes
authors.forename: Paulo
authors.initials: P
authors.lastname: Caramelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000188:drug therapy; D001342:Autonomic Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology*; D001794:Blood Pressure / Q000187:drug effects; D002800:Cholinesterase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D003704:Dementia / Q000150:complications* / Q000188:drug therapy; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007024:Hypotension, Orthostatic / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged
chemical_list: D002800:Cholinesterase Inhibitors