Effect of irbesartan on erectile function in patients with hypertension and metabolic syndrome

Baumhäkel, Magnus; Schlimmer, Nils; Böhm, Michael

doi:10.1038/ijir.2008.28

Cited by 72 publications

(48 citation statements)

References 31 publications

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“…[124][125][126] Angiotensin receptor blockers are also less likely to cause ED than are other antihypertensive agents (eg, diuretics). 127,128 There have been several reports of improvements in erectile function among men using statins with and without PDE5 inhibitors. [129][130][131][132] However, these findings are not consistent with those of Solomon et al, 133 who reported new-onset ED in 22% of 93 high-risk men after 6 months of statin use.…”

Section: Mayo Clinic Proceedingsmentioning

confidence: 99%

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Nehra

Jackson

Miner

et al. 2012

Mayo Clinic Proceedings

421

341

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The Princeton Consensus (Expert Panel) Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The third Princeton Consensus met November 8 to 10, 2010, and had 2 primary objectives. The first objective focused on the evaluation and management of cardiovascular risk in men with erectile dysfunction (ED) and no known cardiovascular disease (CVD), with particular emphasis on identification of men with ED who may require additional cardiologic work-up. The second objective focused on reevaluation and modification of previous recommendations for evaluation of cardiac risk associated with sexual activity in men with known CVD. The Panel's recommendations build on those developed during the first and second Princeton Consensus Conferences, first emphasizing the use of exercise ability and stress testing to ensure that each man's cardiovascular health is consistent with the physical demands of sexual activity before prescribing treatment for ED, and second highlighting the link between ED and CVD, which may be asymptomatic and may benefit from cardiovascular risk reduction. T he Princeton Consensus Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The first conference convened in June 1999 to develop recommendations for clinical management of sexual dysfunction in men and women with known cardiovascular disease (CVD). This conference also provided a multidisciplinary forum for evaluation of the potential cardiovascular risk posed by sexual activity in atrisk patients. The first Princeton Consensus Conference recommendations 1 included stratification of patients by level of cardiac risk associated with sexual activity based on existing CVD. Those at low risk could initiate or resume sexual activity and be treated for sexual dysfunction. For those at high risk, sexual activity was deferred until the cardiac condition was stabilized. The second Princeton Consensus Conference convened in June 2004 and expanded the recommendations of the first conference to emphasize risk factor evaluation and lifestyle management for all men with erectile dysfunction (ED). 2 The second conference recommendations also incorporated new information on the appropriate use of phosphodiesterase type 5 (PDE5) inhibitors in men with ED and concomitant CVD.The third Princeton Consensus Conference took place November 8 to 10, 2010, in Miami Beach, Florida. The group revisited and updated their 2005 recommendations regarding the cardiovascular risk associated with sexual activity in men with known CVD. 2 In addition, the third conference focused on the predictive value of vasculogenic ED in assigning cardiovascular risk in men of all ages, with the primary objective being development of an approach to cardiovascular risk assessment in younger men with ED and no known CVD. The role of testosterone in erectile function and cardiovascular health and the utility of testosterone replacement...

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Section: Mayo Clinic Proceedingsmentioning

confidence: 99%

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Nehra

Jackson

Miner

et al. 2012

Mayo Clinic Proceedings

421

341

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“…The study with irbesartan also showed an improvement in sexual desire, frequency of sexual contacts and erectile function in hypertensive patients with the metabolic syndrome. 13 However, there is no clinical report on ARBs for the treatment of diabetic ED. So we designed this clinical trial with the use of losartan for the treatment of diabetic ED.…”

Section: Introductionmentioning

confidence: 99%

Losartan improves erectile dysfunction in diabetic patients: a clinical trial

et al. 2012

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The activation of cavernous local renin-angiotensin system has an important role in pathogenesis of diabetic erectile dysfunction (ED). In our primary study, we found that angiotensin Type 1 receptor blocker improved the erectile function of diabetic rats. Therefore we explored the losartan in clinical treatment for diabetic patients suffering with ED. A total of 124 diabetic patients with ED were included in this study and treated with losartan or tadalafil or losartan plus tadalafil or watch for waiting as control for 12 weeks. Erectile function was assessed by International Index of Erectile Function (IIEF-5) questionnaire, the percentage of positive responses to sexual encounter profile questions 2 (SEP2), 3 (SEP3) and the global assessment question (GAQ). Losartan or tadalafil or losartan plus tadalafil significantly improved the mean IIEF-5 scores, the percentage of successful penetrations (SEP2), the successful intercourse completions (SEP3) and GAQ (Po0.05). The combination of losartan and tadalafil is more effective than the single-use of losartan or tadalafil (Po0.05). The patients with moderate and mild ED had better response rates to losartan than patients with severe ED. This is the first clinical trial in losartan therapy on diabetic patients suffering from ED. Losartan seems to be effective and well-tolerated in diabetic ED patients, especially for mild to moderate ones. The combination therapy of losartan and tadalafil appeared to be more effective than monotherapy. Keywords: angiotensin type 1 receptor blocker; diabetes; erectile dysfunction; losarton; PDE5 inhibitor INTRODUCTION Erectile dysfunction (ED) is a common complication for diabetic patients. The pathogenesis of diabetic ED is multifactorial, involving the neural, vascular, endocrine and metabolic systems. 1,2 The first-line treatment for diabetic ED is phosphodiesterase Type 5 inhibitors. However, the efficacy of phosphodiesterase Type 5 inhibitors on diabetic ED is only about 51 --62%. 3 --5 Therefore, it is necessary to search for more effective medical therapies for this difficult condition.Our previous study showed that the angiotensin II (Ang II) level in the cavernosum of diabetic rats was much higher than that in normal controls. 6 Kifor et al. 7 reported that exogenous Ang II by ICI could terminate spontaneous erection in dogs, whereas administration of losartan, an Ang II receptor antagonist, resulted in smooth-muscle relaxation and erection. The inhibitor of local renin-angiotensin system (RAS) (angiotensinogen, (pro)renin receptor, angiotensin-converting enzyme, and angiotensin Type I (AT1) receptor ) of cavernosum in diabetic rats was obtained by administration of the angiotensin Type 1 receptor blocker (ARB), losartan. 8 Administration of losantan could also regulate human penile smooth muscle tone 9 and HO-1 gene expression 10 and improves erectile function in diabetic rats. 8 ARBs, a class of selective inhibitors of AT1, such as losartan, valsartan and irbesartan, are medications commonly used for cardiovascular diseas...

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“…[18][19][20][21] However some third generation b-blockers and angiotensin receptor blockers have been associated with improvement of ED due to their protective effects on penile tissue and endothelial function. [22][23][24][25] In summary, causes of ED in HF patients are decreased exercise capacity, depression, endothelial dysfunction and standard HF medications.…”

Section: Introductionmentioning

confidence: 99%

Erectile dysfunction and heart failure: the role of phosphodiesterase type 5 inhibitors

Al-Ameri

Kloner

2009

Int J Impot Res

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The phosphodiesterase type 5 (PDE-5) inhibitors are effective in treating erectile dysfunction (ED). ED and heart failure (HF) share similar risk factors, and commonly present together. This association has led to questions ranging from the safety and efficacy of PDE-5 inhibitors in HF patients to a possible role for this class of medication to treat HF patients with or without ED. In addition to endothelial dysfunction, there are causes of ED specific to patients with HF including low exercise tolerance, depression and HF medications. Before treating HF patients with PDE-5 inhibitors, patients should be assessed for their risk of a cardiac event during sexual activity. PDE-5 inhibitors are safe and effective in treating ED in HF patients. An improvement in erectile function by PDE-5 inhibitors was associated with an improvement in quality of life and reduction in depression. Several studies demonstrated the effect of PDE-5 inhibitors on HF per se. PDE-5 inhibitors improved endothelial dysfunction, increased exercise tolerance, decreased pulmonary vascular resistance and pulmonary artery pressure, and increased cardiac index. Several mechanisms whereby PDE-5 inhibitors improve HF have been proposed. PDE-5 inhibitors already have a role in treating primary pulmonary hypertension; however additional studies are needed to determine if they will become a standard therapy for HF patients.

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Effect of irbesartan on erectile function in patients with hypertension and metabolic syndrome

Cited by 72 publications

References 31 publications

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Losartan improves erectile dysfunction in diabetic patients: a clinical trial

Erectile dysfunction and heart failure: the role of phosphodiesterase type 5 inhibitors

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