Nitric oxide and penile erection: Is erectile dysfunction another manifestation of vascular disease?

Sullivan, M.; Thompson, CS; Dashwood, Michael R.; Khan, Masood; Jeremy, Jamie Y.; Morgan, Robert J.; Mikhailidis, Dimitri P.

doi:10.1016/s0008-6363(99)00135-2

Cited by 248 publications

(180 citation statements)

References 70 publications

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“…23,24 Similar pathogenic involvement of the nitric oxide (NO) pathway leading to the impairment of endothelium-dependent vasodilatation in the early phase, and obstructive vascular changes in the late phase, is shared by ED and other vascular diseases. 25,26 Therefore, atherosclerosis characterized by vascular damage and NO-pathway impairment may partially explain the association between ED, MS and CVD.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and cardiovascular disease risk differences for erectile dysfunction patients by three metabolic syndrome definitions

Chu

Pan

et al. 2011

Int J Impot Res

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There is growing evidence of a link between ED, metabolic syndrome (MS) and cardiovascular disease (CVD). The study was to explore the prevalence of MS using three different definitions (World Health Organization (WHO), International Diabetes Foundation (IDF) and Adult Treatment Panel III (ATP III)), and to compare the association of CVD in ED outpatients using these definitions. This study enrolled 254 participants with a mean age of 55.3±0.9 years (range, 21 to 81 years) with ED as diagnosed by International Index of Erectile Function score. All participants underwent MS evaluation based on the three criteria. Differences of MS prevalence, demographical characteristics, biochemical profiles, pro-inflammatory and inflammatory markers, echocardiographic characteristics and the association with Framingham cardiac risk score (FCRS) were compared. The presence of diabetes mellitus (DM) in the WHO group and high waist girth in the IDF group were significant because of the necessity of respective criteria. The MS prevalence in the WHO, IDF and ATP III groups was 30.7, 34.3 and 36.6%, respectively (P ¼ 0.367). The degrees of agreement among each definition were substantial to perfect. No significant findings in echocardiographic characteristics, biochemical, inflammatory and pro-inflammatory markers were noted. The FCRS showed borderline nonsignificant difference (17.9 ± 0.4, 16.8 ± 0.4 and 16.9 ± 0.4, P ¼ 0.079); however, the FCRS was more closely correlated with the WHO than with the IDF and ATP III (Spearman's correlation coefficients were 0.522, 0.531 and 0.462, respectively; P ¼ 0.021). In patients o 55 years of age and those who smoke, the Spearman's correlation in the WHO group was significantly higher than in the IDF and ATP III groups. The prevalence of the MS using different definitions in ED patients was not different. The WHO-defined MS was more closely associated with CVD.

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Section: Discussionmentioning

confidence: 99%

Prevalence and cardiovascular disease risk differences for erectile dysfunction patients by three metabolic syndrome definitions

Chu

Pan

et al. 2011

Int J Impot Res

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“…1,19,20 Recent studies have shown that the similar pathogenic involvement of the nitric oxide (NO) pathway leading to the early impairment of endothelium-dependent vasodilatation and late obstructive vascular changes is common to both ED and other vascular diseases. 21,22 In 2003, a pathophysiological mechanism, the 'artery-size hypothesis,' was proposed by Montorsi et al to explain the link among ED, CAD, and stroke. 23 Atherosclerosis, a systemic disorder, should theoretically affect all the major vascular beds simultaneously, and to the same extent.…”

Section: Discussionmentioning

confidence: 99%

“…17 Questions 1-5 and 15 of the IIEF constitute the erectile function domain, which is used to assess global erectile function. Scoring the IIEF domain of erectile function allowed the classification of each patient as follows: absent of ED (26)(27)(28)(29)(30), mild ED (17)(18)(19)(20)(21)(22)(23)(24)(25), moderate ED (11)(12)(13)(14)(15)(16) and severe ED (0-10).…”

Section: Methodsmentioning

confidence: 99%

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity

Chu

et al. 2009

Int J Impot Res

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We determined the association between the severity of erectile dysfunction (ED) and traditional cardiovascular risk factors, including metabolic syndrome (MS). A total of 141 ED patients were divided into three groups on the basis of ED severity, which was determined using the International Index of Erectile Function (IIEF) scores. The prevalence of MS among the ED patients was 32.6%. Significantly lower IIEF scores were noted in patients with MS than in patients without MS (7.6±6.4 vs 11.6±7.4, P ¼ 0.003). As assessed by the anthropometric indices of body mass index, waist circumference and waist-to-hip ratio, obesity was detected in 58.9, 54.6 and 32.6% of the patients, respectively. Of the 141 patients, 39 had mild, 24 had moderate and 78 had severe ED. Statistically significant differences were noted among the different ED severity groups with regard to the presence of hypertension, systolic blood pressure, presence of MS and number of MS components. Multivariate analysis showed that the odds ratio for high-low-density lipoprotein (LDL) cholesterol level in moderate and severe ED, determined with reference to mild ED, were 9.346 and 6.452, respectively. The presence of MS, number of MS components, and certain traditional cardiovascular risk factors, particularly high-LDL cholesterol level and hypertension, may influence the severity of ED.

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“…Hyperglycaemia could be the link between ED and endothelial dysfunction in diabetic men. Although it has been suggested that a defect in nitric oxide activity might play a part in the pathogenesis of both ED and ischaemic heart disease [11], so far no study has assessed the association between ED and endothelial functions in diabetic patients without vascular complications. Moreover, the role of coagulation abnormalities has not been evaluated in patients with ED.…”

Section: : 1155±1160]mentioning

confidence: 99%

Erectile and endothelial dysfunction in Type II diabetes: a possible link

et al. 2001

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Erectile dysfunction (ED) is a common complication and an important cause of decreased quality of life in men with diabetes. These patients present a risk of ED three-fold higher than the general population; the prevalence of ED increases with age, but in diabetic men it can occur 10 to 15 years earlier regardless of their insulin dependency status [1].The causes of ED in diabetic patients can be multifactorial, involving mainly vascular, neurological and Diabetologia (2001) AbstractAims/hypothesis. The aim of this study was to evaluate the relation between erectile dysfunction and endothelial functions, coagulation activation, peripheral and autonomic neuropathy in men with Type II (non-insulin-dependent) diabetes mellitus. Methods. We studied 30 Type II diabetic patients with symptomatic erectile dysfunction and 30 potent diabetic patients matched for age and disease. Endothelial functions were assessed with the l-arginine test, plasma thrombomodulin and cell adhesion molecules circulating concentrations. Haemostasis was evaluated with markers of thrombin activation and fibrinolysis. Quantitative sensory testing (vibratory, warming, and heat-pain thresholds), cardiovascular reflex tests and 24-h blood pressure monitoring were used to assess peripheral or autonomic neuropathy. Results. Mean erectile score and HbA 1 c were 10.5 5.8 and 8.3 1.6 % in patients with erectile dysfunction, and 24.0 0.7 and 6.8 1.4 % in those without erectile dysfunction, respectively (p < 0.001); there was a significant relation between HbA 1 c and erectile function score in patients with erectile dysfunction (r = ±0.45, p = 0.02). The decrease in blood pressure and platelet aggregation in response to l-arginine was lower (p < 0.05±0.02) in patients with erectile dysfunction, whereas soluble thrombomodulin, P-selectin and intercellular cell ahhesion molecule-1 concentrations were higher (p < 0.05±0.02). Indices of coagulation activation (F1 + 2 and d-dimers) and reduced fibrinolysis (PAI-1) were also found to be higher in erectile dysfunction patients. Heat-pain and warm perception thresholds, as well as cardiovascular reflex tests, were most commonly abnormal in patients with erectile dysfunction (p < 0.05). In multivariate analysis, HbA 1 c , MBP response to l-arginine, P-selectin, indices of coagulation, and quantitative sensory testing were independent predictors of erectile function score. Conclusion/interpretation. Erectile dysfunction in diabetic men correlates with endothelial dysfunction. A reduced nitric oxide activity might provide a unifying explanation. [Diabetologia (2001

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Nitric oxide and penile erection: Is erectile dysfunction another manifestation of vascular disease?

Cited by 248 publications

References 70 publications

Prevalence and cardiovascular disease risk differences for erectile dysfunction patients by three metabolic syndrome definitions

Prevalence and cardiovascular disease risk differences for erectile dysfunction patients by three metabolic syndrome definitions

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity

Erectile and endothelial dysfunction in Type II diabetes: a possible link

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