Recovery of Erectile Function after Brief Aggressive Antihypertensive Therapy

Hale, Taben M.; Okabe, Hiroaki; Bushfield, Terri L; Heaton, Jeremy P.W.; Adams, Michael

doi:10.1097/00005392-200207000-00103

Cited by 26 publications

(43 citation statements)

References 31 publications

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“…40 Rho kinase has further been shown to have a role in hypertension and its expression correlates to aging, which provides a partial explanation not only for the relationship between LUTS and ED, but also for the connection of LUTS, ED and hypertension. 41 Pelvic atherosclerosis An additional mechanism is diffuse atherosclerosis of blood vessels supplying prostate, penis and bladder. 42 In a recent epidemiologic study that supports this notion, both men and women who had two risk factors of atherosclerosis (diabetes mellitus, hypertension, hyperlipidemia and nicotine use) had a statistically significant higher IPSS compared with subjects with one or no risk factors.…”

Section: Luts and Ed: Pathophysiological Correlationsmentioning

confidence: 99%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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There is strong evidence from multiple epidemological studies that lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are correlated, independent of age or comorbidities as diabetes or hypertension. Although a direct causal relationship is not established yet, four pathophysio logical mechanisms can explain the relationship. These include alteration in nitric oxide bioavailability, a1-adrenergic receptor hyperactivity, pelvic atherosclerosis and sex hormones. This association has different clinical implications on the management of both disorders. Men seeking care for one condition should always be screened for complaints of the other condition. Sexual function should be assessed and discussed with the patient when choosing the appropriate management strategy for LUTS, as well as when evaluating the patient's response to treatment. Multiple large clinical trials have shown an improvement in LUTS after phosphodiesterase-5 (PDE5)-inhibitor treatment. PDE5 inhibitors show promise as a future treatment for LUTS, either in conjunction with existing therapies or as a primary treatment. There may be a potential therapeutic role for testosterone in LUTS treatment in cases of testosterone deficiency that needs to be investigated. Much further investigation is required, but it is evident that the association between LUTS and ED is fundamental for future therapies and possible preventative strategies.

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Section: Luts and Ed: Pathophysiological Correlationsmentioning

confidence: 99%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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“…[1][2][3][4] These effects have been shown in several models of experimental hypertension, including the Prague hypertensive rat 5 and the genetically hypertensive rat, 6,7 although this is best documented in the spontaneously hypertensive rat (SHR). [1][2][3]8,9 The concept that the persistent reduction in MAP and the regression of vascular structure are linked mechanistically has also been widely discussed, although without resolution. 1-4,10 -14 Further, the vascular structural changes that persist off-treatment have been proposed to result from extended inhibition of the trophic actions of angiotensin II, 8,15,16 prolonged reduction in arterial pressure, 16 -18 or from the combined effects.…”

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confidence: 99%

Time Course of Vascular Structural Changes During and After Short-Term Antihypertensive Treatment

et al. 2003

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Abstract-The present study characterized the persistent changes (ie, off-treatment) resulting from short-term antihypertensive treatments on mean arterial pressure (MAP) and structurally based vascular resistance. Rats were treated for 14 days with enalapril (30 mg · kg Ϫ1 · d Ϫ1 ) with regular (ENAL, 0.4%) or low salt (ELS, 0.04%) diets, or a triple therapy (Triple: hydralazine 45 mg · kg Ϫ1 · d Ϫ1

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“…18 Although treatment of hypertension with common antihypertensive medications has been associated with ED, 19,20 another study also showed recovery of erectile function after brief aggressive antihypertensive therapy. 21 Moreover, antihypertensives at levels currently used in clinical settings are not likely to negatively influence ED significantly. 22 Our results suggest that although it may be important to lower HbA1c levels below a clinically important threshold to experience improvement in ED, any reduction in BP may also provide beneficial effects.…”

Section: Discussionmentioning

confidence: 99%

Does cardiovascular risk reduction alleviate erectile dysfunction in men with type II diabetes mellitus?

et al. 2008

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Veterans (N ¼ 41) with type II diabetes were enrolled in a behavioral and pharmacologic intervention for cardiac risk reduction for 4 weeks at the Providence Veterans Affairs Medical Center during 2004-2007 and were followed up 3 months post intervention. Erectile dysfunction (ED) was assessed using the 5-item version of the International Index of Erectile Function (IIEF-5). Participants experienced significant improvements in hemoglobin A1c (HbA1c), diastolic blood pressure and total cholesterol levels over the course of the intervention. Change in systolic and diastolic blood pressure and reduction in or maintenance of HbA1c below 7.0% were significantly associated with change in IIEF-5 (P ¼ 0.01, P ¼ 0.01, P ¼ 0.04, respectively). These results suggest that improved blood pressure and glycemic control in men with diabetes may lead to an improvement in ED.

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Recovery of Erectile Function after Brief Aggressive Antihypertensive Therapy

Cited by 26 publications

References 31 publications

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Time Course of Vascular Structural Changes During and After Short-Term Antihypertensive Treatment

Does cardiovascular risk reduction alleviate erectile dysfunction in men with type II diabetes mellitus?

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