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16 May 2005
Erectile Dysfunction Linked To High Blood Pressure
by George Atkinson

Two independent studies presented at the American Society of Hypertension's Annual Meeting this week have revealed a link between hypertension and erectile dysfunction. "It is estimated that at least 20 million American men have some degree of erectile dysfunction," said researcher Dr. Michael Doumas, from the University of Athens. "Our research determined that for men with high blood pressure, the chances that they may be at risk for or have the devastating condition dramatically increases."

Dr. Doumas and his colleagues studied men between the ages of 31 and 65 years who were evaluated for hypertension and then were asked to complete a questionnaire that evaluated their erectile dysfunction according to the International Index of Erectile Function (IIEF). "The IIEF is widely used considered an accurate test for defining sexual dysfunction," said Doumas.

"Using the IIEF's 'inform-then-probe' technique of questioning, we were able to clearly demonstrate a strong link between high blood pressure and erectile dysfunction."

Overall, 35 percent of the patients exhibiting hypertension had some degree of erectile dysfunction, and 9 percent of these patients had severe erectile dysfunction. By contrast, only 14 percent of patients with normal blood pressure had some degree of the condition, and 2 percent of these patients had severe erectile dysfunction.

In the second study, Dr. Charalambos Vlachopoulos of Athens Medical School, examined the long term effects of sildenafil (the active constituent in Viagra and other impotence drugs) on aortic stiffness. "Sildenafil is widely-used for treatment of erectile dysfunction, but the condition is so prevalent and closely linked to risk factors for coronary artery disease that we wanted to explore the drug's potential beyond erectile dysfunction treatment," said Vlachopoulos. "We found that the drug has a beneficial long-term effect on aortic stiffness, a risk factor for heart attack, stroke and coronary artery disease."

"We have seen in previous studies that patients suffering from ED and those suffering from coronary artery disease both share a common defect, endothelial dysfunction," Dr. Vlachopoulos said. The endothelium is a thin cellular layer that covers the innermost surface of all blood vessels. Endothelial function involves the cells' secretion of important substances, such as nitric oxide, that help control vascular tone and the ability of the vessels to dilate. "Because sildenafil blocks the breakdown of vasodilating substances produced by the endothelium to aid sexual function, we hypothesized that the drug may help reduce aortic stiffness, which is partly dependent on endothelial function," he continued.

Vlachopoulos and colleagues tested men with erectile dysfunction by giving them either sildenafil or placebo, daily, over 2 weeks. The researchers concluded that arterial stiffness decreased for patients on sildenafil. The research team then used pulse wave velocity techniques to measure blood flow as the heart beats. Vlachopoulos said that while the implications of the study were promising, it was only the beginning and more in-depth research would be needed in the future. "We are on the cusp of discovering new beneficial effects that seem to extend beyond sildenafil's acute action," he concluded.

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