Erectile
Dysfunction,
High
Blood
Pressure
Linked
Men with
high blood
pressure
have a new
reason to
get their
condition
under
control -
they may be
at risk for
erectile
dysfunction,
medical
experts
announced
today at the
American
Society of
Hypertension's
Twentieth
Annual
Scientific
Meeting.
Two separate
studies
presented
this week
uncovered a
commonly
hypothesized
link between
the
hypertension
and erectile
dysfunction
(ED). One of
these
studies also
demonstrated
that of
long-term
use of
sildenafil,
a commonly
prescribed
ED
treatment,
was
effective in
improving
aortic
stiffness in
patients
suffering
from the
condition.
"It is
estimated
that at
least 20
million
American men
have some
degree of
erectile
dysfunction,"
said Dr.
Michael
Doumas, from
the 4th
Department
of Internal
Medicine,
University
of Athens,
Greece. "Our
research
determined
that for men
with high
blood
pressure,
the chances
that they
may be at
risk for or
have the
devastating
condition
dramatically
increases."
Dr. Doumas
and
colleagues
studied 634
young and
middle-aged
men between
the ages of
31 and 65
years,
excluding
those with
history of
diabetes
mellitus,
heart
disease,
renal
failure,
liver and
vascular
disease, as
these
diseases
have been
associated
with ED.
Patients
were
evaluated
for
hypertension,
as well as
medical
history, and
then were
asked to
complete out
a
questionnaire
that
evaluated
their ED
according to
the
International
Index of
Erectile
Function (IIEF).
"The IIEF is
widely used
considered
an accurate
test for
defining
sexual
dysfunction,"
said Dr.
Doumas.
"Using the
IIEF's
'inform-then-probe'
technique of
questioning,
we were able
to clearly
demonstrate
a strong
link between
high blood
pressure and
ED."
Overall,
35.2 percent
of the 358
patients had
some degree
of ED, and
9.2 percent
of these
patients had
severe ED
(p<.0001).
By contrast,
only 14.1
percent of
patients
with normal
blood
pressure had
some degree
of the
condition,
and 1.5
percent of
these
patients had
severe ED
(p<.0001).
Interestingly,
erectile
dysfunction
was more
frequent
even in
subjects
with high
normal blood
pressure,
now included
under the
term "prehypertension",
suggesting
that we must
pay special
attention at
this
population.
In a
separate
study
presented at
the meeting,
Dr.
Charalambos
Vlachopoulos,
from the
First
Department
of
Cardiology
at Athens
Medical
School,
Greece,
examined
sildenafil's
long-term
effect on
aortic
stiffness.
"Sildenafil
is
widely-used
for
treatment of
erectile
dysfunction,
but the
condition is
so prevalent
and closely
linked to
risk factors
for coronary
artery
disease that
we wanted to
explore the
drug's
potential
beyond ED
treatment,"
said Dr.
Vlachopoulos.
"We found
that the
drug has a
beneficial
long-term
effect on
aortic
stiffness, a
risk factor
for isolated
systolic
hypertension,
heart
attack,
stroke, and
coronary
artery
disease."
"We have
seen in
previous
studies that
patients
suffering
from ED and
those
suffering
from
coronary
artery
disease both
share a
common
defect,
endothelial
dysfunction,"
Dr.
Vlachopoulos
continued.
"Because
sildenafil
blocks the
breakdown of
vasodilating
substances
produced by
the
endothelium
to aid
sexual
function, we
hypothesized
that the
drug may
help reduce
aortic
stiffness,
which is
partly
dependent on
endothelial
function."
The
endothelium
is a thin
cellular
layer that
covers the
innermost
surface of
all blood
vessels.
Endothelial
function
involves the
cells'
secretion of
important
substances,
such as
nitric
oxide, that
help control
vascular
tone and the
ability of
the vessels
to dilate.
In a
double-blind
study, Dr.
Vlachopoulos
and
colleagues
randomized
11 men with
ED to either
sildenafil
100 mg daily
or placebo
over 2
weeks. At
the end of
two weeks,
the men
receiving
placebo
switched to
sildenafil
100 mg daily
and those
originally
on the ED
treatment
switched to
placebo, and
the study
continued
for another
two weeks.
Pulse wave
velocity was
measured at
baseline, 7
and 14 days,
24 hours
after the
last dose.
The
researchers
concluded
that
arterial
stiffness
decreased
for patients
on
sildenafil.
"Pulse-wave
velocity is
a
non-invasive
method to
measure
aortic
stiffness,
using the
laws of
physics to
analyze
blood flow
as the heart
beats," said
Dr.
Vlachopoulos.
"To be sure
we were
evaluating
the
long-term
effect of
the drug, we
were careful
to take
measurements
well after
the acute
effects of
the
sildenafil
had worn
off."
While the
implications
of this
study are
promising,
Dr.
Vlachopoulos
warned this
study is
only the
beginning of
more
in-depth
research
needed in
the future.
"We are on
the cusp of
discovering
new
beneficial
effects that
seem to
extend
beyond
sildenafil's
acute
action."
About the
American
Society of
Hypertension
The American
Society of
Hypertension
(ASH) is the
largest US
organization
devoted
exclusively
to
hypertension
and related
cardiovascular
diseases.
ASH is
committed to
alerting
physicians,
allied
health
professionals
and the
public about
new medical
options,
facts,
research
findings and
treatment
choices
designed to
reduce the
risk of
cardiovascular
disease.
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