Concurrent Relations among Cigarette Smoking Status, Resting Heart Rate Variability, and Erectile Response

Abstract

Introduction Heart rate variability (HRV) is a marker of sympathovagal balance; it has been implicated in erectile function and is also altered by tobacco use. Furthermore, smoking and erectile health are strongly related, given that smokers are at increased risk for erectile dysfunction. Few studies have explored the interrelationships between smoking, HRV, and erectile function concurrently. Aim The aim of this study was to examine potential mechanisms underlying tobacco's effects on penile hemodynamics by exploring the mediating role of HRV. Methods The sample comprised 119 men (smokers = 64; nonsmokers = 55) (mean age 28.90 years; standard deviation (SD) 11.68; range 18–58) selected from the control conditions of three previously published experiments. Participants were free from a history of cardiovascular disease, myocardial infarct, and/or cardiac/cardiovascular medication use. During a laboratory visit, self-report, anthropometric, cardiovascular, and electrocardiographic data were assessed, as well as sexual arousal responses elicited from viewing an erotic film. Main Outcome Measures Objective sexual arousal indices (circumferential change via penile plethysmography), self-reported erectile function (per the erectile function domain score of the International Index of Erectile Function [IIEF-EF]), and time- (SD of beat-to-beat intervals) and frequency-domain parameters of HRV (ratio of low-frequency [LF] power to high-frequency [HF] power [LF/HF ratio]) were assessed. Results Being a current long-term cigarette smoker was associated with dysregulated sympathovagal balance (higher LF/HF ratios, indicative of sympathetic nervous system dominance), which in turn showed inverse relations with magnitude of erectile tumescence. HRV did not mediate relations between tobacco use and either IIEF-EF scores or resting penile circumference. Conclusions Findings suggest that dysfunctional cardiac autonomic tone may be an underlying mechanism by which tobacco exerts its deleterious effects on erectile health. Further research is necessary to determine whether this relationship is mechanistic in nature, or whether it is better explained by other health factors.

Nicotine Acutely Inhibits Erectile Tumescence by Altering Heart Rate Variability

“…The absence of this mediation effect may be due to the fact that nicotine administration does not appear to affect self-reported sexual arousal 4 , supporting the notion that nicotine attenuates genital arousal peripherally (in part, via HRV) rather than centrally (e.g., by impacting cognitive processes). Similar to findings of recently published reports 13,17 , HRV did not mediate associations between nicotine consumption and RPC. One possible explanation is that HRV plays a role primarily with processes responsible for sexual arousal rather than in resting genital tone.…”

“…Further, findings underscore the possibility that cardiac autonomic tone is an underlying mechanism by which nicotine intake exerts its deleterious effects on erectile response. In fact, recent longitudinal 16 and cross-sectional 17 studies indicate that nicotine/tobacco consumption (and cessation) is associated with several parameters of HRV, which in turn are associated with erectile tumescence. More broadly, findings may point toward the underlying role of HRV in the physiology of erectile hemodynamics, as current findings were in concert with a growing body of literature demonstrating the relationship between sympathovagal balance and erectile function 13–15 .…”

“…Specifically, individuals with ED have been shown to display dysregulated HRV, indicative of impaired cardiac autonomic regulation (i.e., sympathetic hyperactivity) 14,15 . Moreover, smoking, HRV, and erectile health may all be interrelated; longitudinal 16 and cross-sectional studies 17 indicate that HRV mediates the relationship between smoking status and/or smoking intensity and erectile tumescence. These findings highlight the possible underlying role of cardiac autonomic function in the physiology of erection, and point toward a possible mechanism that explains the link between tobacco use and ED.…”

Efficacy of Continuous Dosing of Tadalafil Once Daily vs Tadalafil On Demand in Clinical Subgroups of Men with Erectile Dysfunction: A Descriptive Comparison Using the Integrated Tadalafil Databases

“…Normal erection depends on penile vascular endothelial function, and smoking can have an adverse effect on vascular endothelium and lead to an increased risk for ED. 42–44 Therefore, the weaker effect seen in smokers in this study is not surprising; however, the numbers were small in this subpopulation of patients (<64 patients), so this result should be interpreted with caution.…”

Recuperação Da Variabilidade Da Frequência Cardíaca Após O Tabagismo

“…Chronic smoking reduces the HRV and also results in increased arterial blood pressure, heart rate, vascular resistance, sympathetic flow and decreased baroreflex activity 10 .…”