title: Guanfacine alters the effect of stress and smoking on heart rate variability in regular daily smokers.
abstract: We had previously demonstrated that guanfacine, an α2a-adrenergic agonist, attenuated the effect of stress on smoking-lapse behavior in regular daily smokers. Heart rate variability (HRV), a measure of vagal activity, may be a potential mechanism underlying the relationship between stress, smoking, and relapse.
  
  
  
  We examined whether guanfacine (0 mg/day vs. 3 mg/day; n = 26) altered changes in high-frequency heart rate variability (HF-HRV) following stress and ad-lib smoking using a validated laboratory analogue of smoking-lapse behavior. All participants completed a parent study evaluating the effects of guanfacine on stress-precipitated smoking. Each subject completed two laboratory sessions assessing the effects of guanfacine on HF-HRV following stress imagery (vs. neutral imagery; order counterbalanced) and smoking.
  
  
  
  Results demonstrated that guanfacine did not increase tonic levels of HF-HRV relative to placebo. Following the stress versus neutral imagery manipulation (prior to ad-lib smoking), there were no significant changes in HF-HRV in the placebo group. In contrast, guanfacine increased phasic HF-HRV following stress imagery and decreased HF-HRV following neutral imagery. Ad libitum smoking following both the stress and neutral conditions decreased HF-HRV in the placebo group across both imagery conditions. In contrast, guanfacine attenuated stress- and smoking-related decreases in phasic HF-HRV relative to the neutral imagery condition.
  
  
  
  This is the first demonstration that a noradrenergic target altered dynamic changes in HF-HRV in response to stress and smoking, suggesting that guanfacine alters HF-HRV response to stress. Findings support current theories which suggest that phasic changes in HRV are an important marker of the stress response.
authors.affiliation: Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 201, New Haven, CT, 06519, USA. terril.verplaetse@yale.edu.
authors.forename: Terril L
authors.initials: TL
authors.lastname: Verplaetse
authors.affiliation: Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY, USA.
authors.forename: Philip H
authors.initials: PH
authors.lastname: Smith
authors.affiliation: Division on Substance Abuse, Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Kathryn M Z
authors.initials: KM
authors.lastname: Smith
authors.affiliation: Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 201, New Haven, CT, 06519, USA.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Oberleitner
authors.affiliation: Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 201, New Haven, CT, 06519, USA.
authors.forename: Sherry A
authors.initials: SA
authors.lastname: McKee
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists / Q000494:pharmacology*; D000328:Adult; D005260:Female; D016316:Guanfacine / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000074285:Smokers; D012907:Smoking; D013315:Stress, Psychological / Q000503:physiopathology*; D000073869:Tobacco Smoking / Q000503:physiopathology*; D014630:Vagus Nerve; D055815:Young Adult
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D016316:Guanfacine
keywords: Guanfacine; HF-HRV; Heart rate variability; Noradrenergic; Smoking; Stress