Penile microvascular endothelial function in hypertensive patients: effects of acute type 5 phosphodiesterase inhibition

Abstract

The primary aim of this study was to evaluate penile endothelial microvascular function in patients with primary arterial hypertension and age-matched normotensive subjects using laser speckle contrast imaging (LSCI). Additionally, we analyzed the acute penile microvascular effects induced by oral phosphodiesterase type 5 inhibitor (sildenafil; SIL) administration. Endothelium-dependent microvascular reactivity was evaluated in the penises and forearms of hypertensive patients (aged 58.8±6.6 years, n=34) and age-matched healthy volunteers (n=33) at rest and 60 min following oral SIL (100 mg) administration. LSCI was coupled with cutaneous acetylcholine (ACh) iontophoresis using increasing anodal currents. Basal penile cutaneous vascular conductance (CVC) values were not significantly different between control subjects and hypertensive individuals. Penile CVC values increased significantly after SIL administration in control (P<0.0001) and hypertensive (P<0.0001) subjects. Peak CVC values were not different between the two groups during penile ACh iontophoresis before SIL administration (P=0.2052). Peak CVC values were higher in control subjects than in hypertensive subjects after SIL administration (P=0.0427). Penile endothelium-dependent microvascular function is, to some extent, preserved in patients presenting with primary arterial hypertension under effective anti-hypertensive treatment. LSCI may be a valuable non-invasive tool for the evaluation of penile vascular responses to phosphodiesterase type 5 inhibitor.

Nailfold video-capillaroscopy in the study of cardiovascular disease: a systematic review

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Systemic microvascular endothelial dysfunction is associated with left ventricular ejection fraction reduction in chronic Chagas disease patients

“…In this method, the intensity and the duration of the current, as well as the nature of the skin surface (thickness, glabrous or not), may play a crucial role. Nevertheless, it is noteworthy that Ach iontophoresis has been standardized 9 and extensively used by our research group to assess microvascular endothelium‐dependent vasodilation in cardiovascular and metabolic diseases, including arterial hypertension 34 , and diabetes 35 …”

Microcirculation and Cardiovascular Diseases

“…Recently, we adapted the LSCI technique for noninvasive assessment of penile microvascular reactivity. 14 In that study, we demonstrated that LSCI can be used to assess the effects of type 5 phosphodiesterase inhibitors on penile microcirculation in patients with hypertension and erectile dysfunction. 14 …”