1
|
Peng H, Zhang H, Xin S, Li H, Liu X, Wang T, Liu J, Zhang Y, Song W. Associations between Erectile Dysfunction and Vascular Parameters: A Systematic Review and Meta-Analysis. World J Mens Health 2024; 42:42.e18. [PMID: 38311372 DOI: 10.5534/wjmh.230192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/13/2023] [Accepted: 10/03/2023] [Indexed: 02/10/2024] Open
Abstract
PURPOSE Erectile dysfunction (ED) is associated with several vascular disorders, but the associations between ED and vascular parameters are still unclear. MATERIALS AND METHODS We analyzed and synthesized a comprehensive range of studies from PubMed, Web of Science, and Scopus regarding the associations between ED and the following measures: ankle-brachial index (ABI), pulse wave velocity (PWV), intima-media thickness (IMT), nitrate-mediated dilation (NMD), flow-mediated dilation (FMD), augmentation index (AI), endothelial progenitor cells (EPCs) and other vascular parameters. Subgroup analysis was conducted according to specific types of parameters. Study quality was assessed by using the Newcastle-Ottawa Scale. Sensitivity analysis was conducted to confirm the robustness of the pooled results. RESULTS Fifty-seven studies with 7,312 individuals were included. Twenty-eight studies were considered to be high-quality. ED patients had a 0.11 mm higher IMT (95% confidence interval [CI]: 0.07, 0.15), a 2.86% lower FMD (95% CI: -3.56, -2.17), a 2.34% lower NMD (95% CI: -3.37, -1.31), a 2.83% higher AI (95% CI: 0.02, 5.63), a 1.11 m/s higher PWV (95% CI: 0.01, 2.21), and a 0.72% lower percentage of EPCs (95% CI: -1.19, -0.24) compared to those without ED. However, ABI was similar between ED patients and non-ED individuals. According to sensitivity analysis, the pooled results were robust. CONCLUSIONS Our study confirmed the associations between ED and several vascular parameters and highlighted the importance of prevention and management of vascular and endothelial dysfunction in ED patients.
Collapse
Affiliation(s)
- Hao Peng
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- The Second Clinical School, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hanlin Zhang
- The First Clinical School, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Xin
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaming Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yucong Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Wen Song
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
2
|
Lou IX, Chen J, Ali K, Chen Q. Relationship Between Hypertension, Antihypertensive Drugs and Sexual Dysfunction in Men and Women: A Literature Review. Vasc Health Risk Manag 2023; 19:691-705. [PMID: 37941540 PMCID: PMC10629452 DOI: 10.2147/vhrm.s439334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
Sexual dysfunction pertains to any issue that hinders an individual from attaining sexual contentment. This health issue can have a significant impact on the quality of life and psychological health of affected individuals. Sexual dysfunction can generate stress, anxiety, depression, and low self-esteem, which can lead to a reduction in overall life satisfaction and the quality of interpersonal relationships. Sexual dysfunction can manifest as erectile dysfunction in men or lack of sexual desire in women. Although both sexes can experience sexual problems, there are some significant differences in the manifestation of sexual dysfunction between men and women. In men, sexual dysfunction is usually physical and associated with problems such as erectile dysfunction, while in women, sexual dysfunction is usually related to psychological factors. Additionally, there was an association between hypertension and sexual dysfunction in both the sexes. In men, hypertension can cause erection problems, whereas in women, it can cause vaginal dryness and a decrease in sexual desire. Furthermore, antihypertensive drugs can negatively impact sexual function, which can decrease adherence to drug treatment. However, nebivolol, an antihypertensive drug, has beneficial effects on erectile dysfunction in men. This is believed to be because nebivolol improves blood flow to the penis by producing nitric oxide, which can help improve erections.
Collapse
Affiliation(s)
- Inmaculada Xu Lou
- Department of Cardiology, International Education College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People’s Republic of China
- Department of Cardiology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, 310025, People’s Republic of China
| | - Jiayue Chen
- Department of Cardiology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, 310025, People’s Republic of China
- Department of Cardiology, Hangzhou Clinical Medical College Internal Medicine of Traditional Chinese Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People’s Republic of China
| | - Kamran Ali
- Department of Oncology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, People’s Republic of China
| | - Qilan Chen
- Department of Cardiology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, 310025, People’s Republic of China
| |
Collapse
|
3
|
Altunkol A, Topuz AN, Genç Ö, Alma E, Topuz M. Atrial electromechanical duration prolongs in patients with erectile dysfunction. Aging Male 2020; 23:154-160. [PMID: 31389751 DOI: 10.1080/13685538.2019.1650336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: It is well known that erectile dysfunction (ED) is associated with increased risk of atrial fibrillation (AF) development. On the other hand, prolongation of the duration of atrial electromechanical delay (AEMD) is known to be a precursor for AF development. We aimed to evaluate AEMD in patients with ED patients without documented AF.Methods: Total of 68 outpatients with previously documented vascular ED and 44 participants without ED were enrolled to the current study. Sixty-eight patients with ED called as ED group and 44 participants without ED served as control group. We performed International Index of Erectile Function (IIEF-5) questionnaire for all participants to determine the disease severity of ED groups and to diagnose ED in control groups. Patients with a IIEF-5 score ≥22 were defined as having normal erectile functions. Both intra- and inter-AEMD were measured with tissue Doppler imaging. P-wave dispersion (PWD) was measured on a 12-lead electrocardiogram.Results: Basal characteristics were similar between the two groups. PWD, inter- and right intra-AEMD were significantly prolonged in patients with ED, compared to the control group (p = .02, p < .001 and p < .001, respectively). In the correlation analysis, IIEF-5 score was significantly negative correlated with systolic blood pressure, right intra- and inter-AEMD (r = -0.37, p = .02; r= -0.27, p = .02; r = -0.39, p = .001, respectively).Conclusions: According to current study results, AEMD is significantly correlated with ED severity and may be useful to stratify ED patients to the high-risk group for future development of AF as a cheap and easy method.
Collapse
Affiliation(s)
- Adem Altunkol
- Department of Urology, University of Health Sciences, Adana City Teaching and Research Hospital, Adana, Turkey
| | - Ayşe Nur Topuz
- Department of Family Medicine, Public Health Institution of Çukurova, Adana, Turkey
| | - Ömer Genç
- Department of Cardiology, University of Health Sciences Adana City Teaching and Research Hospital, Adana, Turkey
| | - Ergün Alma
- Department of Urology, University of Health Sciences, Adana City Teaching and Research Hospital, Adana, Turkey
| | - Mustafa Topuz
- Department of Cardiology, University of Health Sciences Adana City Teaching and Research Hospital, Adana, Turkey
| |
Collapse
|
4
|
Dzenkeviciute V, Petrulioniene Z, Rinkuniene E, Sapoka V, Petrylaite M, Badariene J. Cardiorenal Determinants of Erectile Dysfunction in Primary Prevention: A Cross-Sectional Study. Med Princ Pract 2018; 27:73-79. [PMID: 29131062 PMCID: PMC5968257 DOI: 10.1159/000484949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 11/05/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the association between the severity of erectile dysfunction (ED), cardiovascular risk, and target organ damage (heart, renal, vascular) in men free of cardiovascular diseases (CVD). SUBJECTS AND METHODS ED was assessed using the International Index of Erectile Function (IIEF-5). The study included 182 men: 100 with ED (IIEF mean score ≤21) and 82 without ED (IIEF mean score >21). Ultrasound was used to evaluate carotid plaques and left ventricular mass, geometry, and diastolic function. Cardiovascular anamnesis, CVD risk factors, and anthropometric and biochemical parameters were obtained. The European Society of Cardiology-Systematic Coronary Risk Evaluation Score (ESC-SCORE) was used to calculate total patient cardiovascular risk. Continuous variables between groups were compared using the Student t test and Mann-Whitney U test, while categorical data were compared using the χ2 test. Multiple linear regression was used to test the association between the severity of ED and presence of target organ damage. RESULTS The following parameters were significantly higher in the ED group compared to the controls: family history of coronary heart disease (43.7 vs. 26.7%, p = 0.047), ESC-SCORE (2.27 ± 1.79 vs. 1.61 ± 1.13, p = 0.012), and waist circumference (109.28 ± 10.82 vs. 106.17 ± 10.07, p = 0.047). Impaired renal function (p = 0.081), albuminuria (p = 0.545), vascular damage (p = 0.602), and diastolic function (p = 0.724) were similar in both groups. However, left ventricular hypertrophy (LVH; odds ratio 2.231, 95% CI 1.069-4.655, p = 0.22) was more frequent in the ED group (29.9 vs. 16.0%). The multiple linear regression analysis revealed that LVH (β = 1.761, p = 0.002) and impaired renal function assessed using the estimated glomerular filtration rate (<60 mL/min/1.73 m2; β = 6.207, p = 0.0001) were the independent risk factors for severity of ED. CONCLUSION This study showed that LVH and impaired renal function are associated with ED severity.
Collapse
Affiliation(s)
- Vilma Dzenkeviciute
- Clinic of Internal Medicine, Oncology and Family Medicine, Vilnius University, Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- *Vilma Dzenkeviciute, Clinic of Internal Medicine, Oncology and Family Medicine, Faculty of Medicine, Vilnius University, Santariškių 2, LT-08611 Vilnius (Lithuania), E-Mail
| | - Zaneta Petrulioniene
- Clinic of Heart and Vascular Medicine, Vilnius University, Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Egidija Rinkuniene
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Virginijus Sapoka
- Clinic of Internal Medicine, Oncology and Family Medicine, Vilnius University, Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | | | - Jolita Badariene
- Clinic of Heart and Vascular Medicine, Vilnius University, Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| |
Collapse
|
5
|
Heikkilä A, Kaipia A, Venermo M, Kautiainen H, Korhonen P. Relationship of Blood Pressure and Erectile Dysfunction in Men Without Previously Diagnosed Hypertension. J Sex Med 2017; 14:1336-1341. [PMID: 28993149 DOI: 10.1016/j.jsxm.2017.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/04/2017] [Accepted: 09/10/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Erectile dysfunction (ED) is the most common male sexual disorder that affects all age groups and has a close association with essential hypertension. AIM To characterize the relation of blood pressure and ED in detail. METHODS A cross-sectional population-based study of 45- to 70-year-old men without previously diagnosed hypertension, cardiovascular diseases, renal disease, or diabetes was conducted from 2005 to 2007 in southwestern Finland. A total of 665 men with at least one cardiovascular risk factor were studied. ED was defined by the five-item International Index of Erectile Function. OUTCOMES We found a U-shaped association between diastolic blood pressure (DBP) and prevalence of ED. RESULTS The average age of the study subjects was 56 ± 6 years and 52% had ED. After adjustment for age, cohabitation status, education, fasting plasma glucose level, waist circumference, and prevalence of depressive symptoms, the curve relating DBP to the prevalence of ED was U-shaped with a nadir of DBP 90 mm Hg. CLINICAL IMPLICATIONS Our findings emphasize the importance of blood pressure measurement in the physical examination of men with ED. STRENGTHS AND LIMITATIONS This was a cross-sectional study, which prevents the evaluation of causality between ED and hypertension. However, this community-based study population is well defined and the anthropologic measurements were made by trained medical staff. CONCLUSION We found a U-shaped correlation between ED and DBP, which confirms the link between ED and hypertension. Heikkilä A, Kaipia A, Venermo M, et al. Relationship of Blood Pressure and Erectile Dysfunction in Men Without Previously Diagnosed Hypertension. J Sex Med 2017;14:1336-1341.
Collapse
Affiliation(s)
- Arto Heikkilä
- Department of General Practice, Turku University and Turku University Hospital, Turku University, Turku, Finland.
| | - Antti Kaipia
- Department of Surgery, Satakunta Hospital District, Pori, Finland
| | - Maarit Venermo
- Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland; Folkhälsan Research Centre, Helsinki, University of Helsinki, Helsinki, Finland
| | - Päivi Korhonen
- Department of General Practice, Turku University and Turku University Hospital, Turku University, Turku, Finland; Central Satakunta Health Federation of Municipalities, Harjavalta, Finland
| |
Collapse
|