Effect of tadalafil and 3-hydroxy-3-methylglutaryl coenzyme A inhibitor statin on the haemodynamics of cavernous and brachial arteries

Abstract

Erectile dysfunction (ED) is usually associated with cardiovascular disease and reduced endothelial function. The aim of the present study was to examine the effect of tadalafil and statin on the endothelial function of cavernous and brachial arteries in healthy men and in patients with ED. The cases included in the study were as follows: 150 men with ED complaints for at least 6 months, and 50 healthy volunteers without sexual problems. Patients were randomly divided into four groups of equal numbers. Group 1 received 20 mg of tadalafil on alternate days, Group 2 received 10 mg of statin a day, Group 3 received tadalafil on alternate days and 10 mg of statin a day, and the last group served as controls. Noninvasive evaluation of brachial artery flow-mediated dilatation (FMD) and percentage of increase in cavernosal arteries diameter (PICAD) was conducted via ultrasound at baseline and 4 weeks after administration of tadalafil or atorvastatin. Before drug administration, FMD and PICAD values did not significantly differ among the three treatment groups. After drug administration, FMD and PICAD values significantly increased in patients receiving tadalafil and tadalafil+statin (P < 0.001), but not in patients receiving only statin. These findings suggested that use of tadalafil alone and tadalafil combined with statin improved endothelial function of cavernous and brachial arteries.

Lower urinary tract symptoms/benign prostatic hypertrophy and vascular function: Role of the nitric oxide–phosphodiesterase type 5–cyclic guanosine 3′,5′‐monophosphate pathway

“…We have also shown that administration of sildenafil induces vasodilation in forearm circulation, and increases both the ACh‐induced and SNP‐induced vasodilation in both smokers and non‐smokers; that sildenafil increases the ratio of ACh‐induced vasodilation to the ratio of SNP‐induced vasodilation; and that the NOS inhibitor l ‐NMMA diminishes the augmentation of ACh‐induced vasodilation after administration of sildenafil, suggesting that inhibition of PDE5 increases NO‐induced vasodilation . The effects of PDE5 inhibitors on endothelial function in patients with ED/LUTS/BPH are summarized in Table . These findings suggest that the mechanism by which PDE5 inhibitors augment or improve vascular function, including endothelial function and vascular smooth muscle function, is mainly activation of the eNOS–NO–cGMP pathway.…”

Improvement in erectile function in a rat model of high cholesterol diet-induced atherosclerosis by atorvastatin in a manner that is independent of its lipid-lowering property

“…Statins were also proven to improve erectile function in ED patients that were initially irresponsive to PDE5i in human studies, in combination with PDE5i (Dadkhah et al., ) or alone (El‐Sisi, Hegazy, Salem, & AbdElkawy, ). Statins administration improved the endothelial function and endothelial NO‐mediated smooth muscle cell relaxation in cavernosum and thus provided an evidential proof of statins in ED therapy (Simsek et al., ).…”

“…Three‐hydroxy‐3‐methylglutaryl coenzyme A (HMG‐CoA) reductase inhibitors, or statins, are used in lowering lipids levels in clinical practice. The beneficial effects of statins on erectile function have been evidenced in several clinical and animal studies (Laufs et al., ; Rendell et al., ; Simsek, Ozbek, & Oncu, ; Wassmann et al., ). The improvement in erectile function induced by statins was not simply derived from its lipid‐lowering properties (Gokkaya et al., ).…”