New insights into hypertension-associated erectile dysfunction

Abstract

Purpose of review Erectile dysfunction (ED) is recognized as a quality of life disorder that needs to be treated. Currently, it is estimated to affect as many as 30 million American men. Thirty percent of hypertensive patients complain of ED. The understanding of common mechanisms involved in the etiology of ED associated with hypertension, and the investigation of antihypertensive drugs that impact ED, will provide important tools toward indentifying new therapeutic targets that will improve the quality of life for patients in these conditions. Recent findings Hypertension and ED are closely intertwined diseases which have endothelium dysfunction as a common base. During hypertension and/or ED, disturbance of endothelium derived factors can lead to an increase in vascular smooth muscle (VSM) contraction. Hypertension can also lead to ED as a consequence of high blood pressure (BP) or due to antihypertensive treatment. However, growing evidence suggests ED as an early sign for hypertension. Also, some PDE-5 inhibitors used to treat ED can improve BP, but the link between these conditions has not been totally understood. Summary This review will discuss the interplay between hypertension and ED, exploring newest insights regarding hypertension-associated ED, as well as the effect of antihypertensive drugs in ED patients.

Role of Adenosine Receptor(s) in the Control of Vascular Tone in the Mouse Pudendal Artery

“…Those factors, which regulate contraction and relaxation of vascular smooth muscle, determine the state of the penis (flaccidity versus erection) (Andersson, 2001;Tostes et al, 2007;Nunes et al, 2012). The flaccid state is mainly mediated by the release of norepinephrine from adrenergic nerve terminals and other vasoconstrictors, such as endothelin-1 and angiotensin II (Sáenz de Tejada et al, 1989, 2004.…”

Erectile Dysfunction and Target Organ Damage

“…Several lines of evidence indicate that drugs used in the treatment of hypertension can indeed deteriorate sexual function, but such an effect appears mainly with older generation drugs (older beta blockers, diuretics), while newer agents (nebivolol, renin-angiotensin-aldosterone system blockers) might even improve sexual function [ 27 ]. On the other hand, hypertension appears to cause ED per se, through a multitude of mechanisms that include prolonged exposure to elevated levels of systemic blood pressure, endothelial dysfunction and circulation of vasoactive substances (with a pivotal role of angiotensin II) that lead to structural and functional alterations in the penile arteries [ 28 ]. Penile doppler studies have shown that the presence of hypertension is associated with a approximately twofold increase in the likelihood of having an abnormal penile blood fl ow [ 29 ].…”

Engineering synthetic optogenetic networks for biomedical applications

“…Erectile dysfunction can occur due to both physiological and psychological reasons including diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease [69][70][71][72]. cGMP specific phosphodiesterase inhibitors such as Viagra® have been used to treat erectile dysfunction by suppressing cGMP and extending erection time.…”