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They are characterized by a change in the autonomic nervous system balance, highlighted by an increase in sympathetic activity associated with a decrease in parasympathetic activity. Most therapeutic approaches seek to treat these diseases by medications that attenuate sympathetic activity. However, there is a growing number of studies demonstrating that the improvement of parasympathetic function, by means of pharmacological or electrical stimulation, can be an effective tool for the treatment of these cardiovascular diseases. Therefore, this review aims to describe the advances reported by experimental and clinical studies that addressed the potential of cholinergic stimulation to prevent autonomic and cardiovascular imbalance in hypertension and heart failure. Overall, the published data reviewed demonstrate that the use of central or peripheral acetylcholinesterase inhibitors is efficient to improve the autonomic imbalance and hemodynamic changes observed in heart failure and hypertension. Of note, the baroreflex and the vagus nerve activation have been shown to be safe and effective approaches to be used as an alternative treatment for these cardiovascular diseases. In conclusion, pharmacological and electrical stimulation of the parasympathetic nervous system has the potential to be used as a therapeutic tool for the treatment of hypertension and heart failure, deserving to be more explored in the clinical setting.<\/jats:p>","DOI":"10.1111\/apha.13663","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T06:38:36Z","timestamp":1619073516000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Benefits of pharmacological and electrical cholinergic stimulation in hypertension and heart failure"],"prefix":"10.1111","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6603-2935","authenticated-orcid":false,"given":"Gisele L.","family":"Cavalcante","sequence":"first","affiliation":[{"name":"Graduate Program in Pharmaceutical Sciences Department of Biophysics and Physiology Federal University of Piaui Teresina PI Brazil"},{"name":"Department of Pharmacology Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo Ribeir\u00e3o Preto SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5042-1319","authenticated-orcid":false,"given":"Fernanda","family":"Brognara","sequence":"additional","affiliation":[{"name":"Department of Physiology Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo Ribeir\u00e3o Preto SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3123-6679","authenticated-orcid":false,"given":"Lucas Vaz de C.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Graduate Program in Pharmaceutical Sciences Department of Biophysics and Physiology Federal University of Piaui Teresina PI Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9183-3926","authenticated-orcid":false,"given":"Renata M.","family":"Lataro","sequence":"additional","affiliation":[{"name":"Department of Physiological Sciences Center of Biological Sciences Federal University of Santa Catarina Florian\u00f3polis SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5625-4662","authenticated-orcid":false,"given":"Marina de T.","family":"Durand","sequence":"additional","affiliation":[{"name":"Medical School of University of Ribeir\u00e3o Preto Ribeir\u00e3o Preto SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3286-4295","authenticated-orcid":false,"given":"Aldeidia P.","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Graduate Program in Pharmacology Department of Biophysics and Physiology Federal University of Piaui Teresina PI Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3830-2886","authenticated-orcid":false,"given":"Ant\u00f4nio Cl\u00e1udio L.","family":"da N\u00f3brega","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Fluminense Federal University Niter\u00f3i RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7351-5740","authenticated-orcid":false,"given":"Helio C.","family":"Salgado","sequence":"additional","affiliation":[{"name":"Department of Physiology Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo Ribeir\u00e3o Preto SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4068-1221","authenticated-orcid":false,"given":"Jo\u00e3o Paulo J.","family":"Sabino","sequence":"additional","affiliation":[{"name":"Graduate Program in Pharmaceutical Sciences Department of Biophysics and Physiology Federal University of Piaui Teresina PI Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31919-5"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000558"},{"issue":"12","key":"e_1_2_9_4_1","first-page":"2667","article-title":"Global cardiovascular health promotion and disease prevention: 2011 and beyond","volume":"125","author":"Labarthe D","year":"2012","journal-title":"Am Heart Assoc"},{"key":"e_1_2_9_5_1","unstructured":"GosseP CremerA VircoulonM CoulonP.Prognostic value of the extent of left ventricular hypertrophy and its evolution in the hypertensive patient.journals.lww.com.2012.https:\/\/journals.lww.com\/jhypertension\/Fulltext\/2012\/12000\/Prognostic_value_of_the_extent_of_left_ventricular.23.aspx?casa_token=5I582djAkx4AAAAA:7Llpm_NDBVoxfXyEHstP6QPvPFNX4C90lxPYMzhK91h\u2010dUf0jPSKfrscnGinBI\u2010afoaYifxE1TIayzdwNDIVC2bKDb4. 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