By Margus Viigimaa, Charalambos Vlachopoulos, Michael Doumas
This concise consultant to the customarily neglected organization among erectile disorder and hypertension/cardiovascular sickness covers a variety of elements of value to the clinician. It examines the impression of antihypertensive drug remedy on erectile functionality and explains how the administration of erectile disorder in hypertensive sufferers depends upon various elements. diverse therapy methods are defined, together with way of life amendment, PDE-5 inhibitors and different novel brokers and behavioral treatment and invaluable healing algorithms are provided. one other concentration of the ebook is the capability function of erectile disorder as an early diagnostic indicator of asymptomatic coronary artery ailment and a prognostic marker for cardiovascular occasions. furthermore, key history details is provided on epidemiology and pathophysiology, and the importance of erectile disorder in several sufferer teams, corresponding to the aged and people with power kidney disorder, is tested. Erectile disorder is an incredible public sickness affecting greater than ten percentage of the overall male inhabitants and is now thought of to be predominantly of vascular beginning. This e-book can be informative and of sensible price for all practitioners chargeable for taking care of the very many sufferers who adventure erectile disorder within the environment of high blood pressure and cardiovascular disease.
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Extra info for Erectile Dysfunction in Hypertension and Cardiovascular Disease: A Guide for Clinicians
Eur J Pharmacol 412: 155–169 33. Panza JA, Quyyumi AA, Brush JE Jr, Epstein SE (1990) Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension. N Engl J Med 323:22–27 34. Taddei S, Virdis A, Ghiadoni L et al (1998) Vitamin C improves endothelium dependent vasodilation by restoring nitric oxide activity in essential hypertension. Circulation 97:2222–2229 35. Koldny RC, Kahn CB, Goldstein HH (1973) Sexual function in diabetic men. Diabetes 23:306–309 36. McCulloch DK, Young RJ, Prescott RJ et al (1984) The natural history of impotence in diabetic men.
The study by Vigen et al. retrospectively compared rates of death, myocardial infarction, and stroke from a dataset of 8,709 men who had undergone coronary angiography with prior documentation of serum T concentration <300 ng/dL; however, credibility of this article is deeply compromised by major errors, and subsequent attempts to correct, in values presented . It cannot be overemphasized, therefore, that prospective data from large, well-designed, long-term trials of TTh in hypertensive males without clinical atherosclerosis are warranted.
In fact, several preclinical and clinical studies report beneficial outcomes on the sexual function by ACEi and ARB treatment [45–53]. In a hypertension-induced ED rat model, captopril treatment normalized both the blood pressure and erectile response, completely restoring the impaired erectile function . Accordingly, in a rat model of diabetes-induced ED, losartan treatment markedly improved the erectile response . Additionally, in a mouse model of hypercholesterolemia-induced ED, both telmisartan and ramipril (ARBs and ACEi respectively) restored the impaired cavernosal endothelial function by reducing the oxidative stress and normalizing the endothelial nitric oxide synthase expression .