Effect of systemic arterial pressure on erectile dysfunction in the initial stages of chronic arterial insufficiency

Abstract

Study Type – Prognosis (case series) Level of Evidence 4 OBJECTIVE To report the effect of systemic arterial pressure on erectile dysfunction (ED) in patients in the initial stages of peripheral arterial disease. PATIENTS AND METHODS All patients with a diagnosis of ED in the urology outpatient clinic of the Medicine School in São José do Rio Preto, Brazil were evaluated in a cross‐sectional, quantitative study. The patients were assessed using the International Index of Erectile Function, the ankle‐brachial index, and measurement of arterial blood pressure. Binary logistic regression, log‐likelihood, Pearson chi‐square and likelihood ratio chi‐square and Kruskal–Wallis Test were used for statistical analysis with P < 0.05 being considered acceptable. Fifty‐two patients (mean age 56.63 years) were enrolled in the study. RESULTS Differences were detected between the median grades of ED of patients with differing degrees of chronic arterial insufficiency. Hypertensive patients in the initial stages of peripheral arterial disease had less severe grades of ED than normotensive patients. CONCLUSIONS The progression of ED parallels the development of chronic arterial insufficiency. Systemic arterial hypertension in the initial stages of peripheral arterial disease might protect against ED, but peripheral arterial disease constitutes an aggravating factor for ED, and thus hypertension might exert a paradoxical effect in this stage of the disease.

Impact of Hypertension, Aging, and Antihypertensive Treatment on the Morphology of the Pudendal Artery

“…ED impacts over 30 million men in North America between the ages of 40 and 70, and significantly affects the quality of life of men and their partners ISSM 2010 Jean Francois Ginestie Prize [7,8]. Recent studies have suggested that nearly 70% of hypertensive males have some degree of ED and hypertension is one of the most common co-morbidities [9][10][11][12][13].…”

Increased expression of insulin-like growth factor-binding protein-3 is implicated in erectile dysfunction in two-kidney one-clip hypertensive rats after propranolol treatment

“…On the one hand, it worsens ED as a result of chronic arterial insufficiency due to the progression of atherosclerosis; on the other hand, it overcomes the obstruction of penile artery stenosis in the initial stages of the disease by directly interfering with pulse pressure. 19 Our findings suggest that decreased cGMP concentration may contribute to ED in the penile tissue of the 2K-1C hypertensive rats after propranolol treatment.…”

“…18 Hypertension might protect against ED in the initial stages of chronic arterial insufficiency. 19 However, later on, hypertension has contradictory effects on ED. On the one hand, it worsens ED as a result of chronic arterial insufficiency due to the progression of atherosclerosis; on the other hand, it overcomes the obstruction of penile artery stenosis in the initial stages of the disease by directly interfering with pulse pressure.…”

Measuring and Evaluating Function, Impairment, and Change with Intervention

“…Systemic arterial hypertension in the initial stages of peripheral arterial disease might protect against ED, but peripheral arterial disease constitutes an aggravating factor for ED, and thus hypertension might exert a paradoxical effect in this stage of the disease. 6 What is proposed here is that based on the results of assessments, blood vessels appear in some individuals to age and produce "chronic arterial insufficiency" leading to ED. The overall clinical picture suggested that blood pressure rises as a compensatory adjustment perhaps to maintain sexual function.…”