Correlations of the Circadian Rhythmicity of Blood Pressure With Erectile Dysfunction

Overview

Journal J Clin Hypertens (Greenwich)

Specialty Cardiology & Vascular Diseases

Date 2024 Nov 15

PMID 39545797

Authors

Ajar Kocak

Cem Senol

Onur Yildirim

Bilgesu Arikan Ergun

Affiliations

Soon will be listed here.

Abstract

Erectile dysfunction (ED) and cardiovascular diseases (CVD) share common pathophysiological mechanisms. This study aimed to assess the relationship between ED and its severity with the risk of developing CVD by analyzing changes in the circadian blood pressure (BP) rhythm. In the study, 24-h BP levels of 192 (94 with ED and 98 controls) participants with no history of CVD were evaluated using an ambulatory blood pressure monitoring (ABPM) device. The International Index of Erectile Function (IIEF) questionnaire was used to assess the ED severity in the study group. ABPM measurements revealed higher BP values among the ED group. The nondipper pattern was significantly more frequent in the ED group compared to the controls (56.2% vs. 77.1%, p < 0.01). Blood pressure variability parameters, including systolic standard deviation (SD) and average real variability (ARV), were notably higher in the ED group (16.3 ± 3.9 vs. 14.6 ± 4.3, p < 0.01 and 13.39 ± 7.24 vs. 11.5 ± 2.1, p < 0.01, respectively). Furthermore, parameters reflecting arterial stiffness including pulse pressure index (PPI) and ambulatory arterial stiffness index (AASI) were higher in the ED group (0.81 ± 0.33 vs. 0.73 ± 0.18, p = 0.03 and 0.71 ± 0.09 vs. 0.59 ± 0.17, p = 0.014, respectively). Both AASI and ARV were significantly correlated with the severity of ED. This study suggests a significant association between ED severity and altered blood pressure patterns which in part explains the increased risk of CVD among individuals with ED.

References

Maestre-Loren F, Castillo-Garayoa J, Lopez-I-Martin X, Sarquella-Geli J, Andres A, Cifre I . Psychological Distress in Erectile Dysfunction: The Moderating Role of Attachment. Sex Med. 2021; 9(5):100436. PMC: 8498960. DOI: 10.1016/j.esxm.2021.100436. View

Peng-Lin Y, Yue-Chun L . Pulse pressure index (pulse pressure/systolic pressure) may be better than pulse pressure for assessment of cardiovascular outcomes. Med Hypotheses. 2009; 72(6):729-31. DOI: 10.1016/j.mehy.2008.12.041. View

Ozdabakoglu O, Gullulu S, Sag S, Senturk T, Kilicarslan H, Tutuncu A . Evaluation of arterial stiffness and cardiac function in patients with vascular erectile dysfunction: acute effects of phosphodiesterase-5 inhibitor tadalafil. Int J Impot Res. 2016; 29(3):96-100. DOI: 10.1038/ijir.2016.47. View

Spallone V . Blood Pressure Variability and Autonomic Dysfunction. Curr Diab Rep. 2018; 18(12):137. DOI: 10.1007/s11892-018-1108-z. View

Grassi G, Bombelli M, Brambilla G, Trevano F, DellOro R, Mancia G . Total cardiovascular risk, blood pressure variability and adrenergic overdrive in hypertension: evidence, mechanisms and clinical implications. Curr Hypertens Rep. 2012; 14(4):333-8. DOI: 10.1007/s11906-012-0273-8. View

Verbakel J, Adiyaman A, Kraayvanger N, Dechering D, Postma C . The Use of the Ambulatory Arterial Stiffness Index in Patients Suspected of Secondary Hypertension. Front Cardiovasc Med. 2016; 3:50. PMC: 5156655. DOI: 10.3389/fcvm.2016.00050. View

Sarma A, Hotaling J, de Boer I, Dunn R, Oerline M, Singh K . Blood pressure, antihypertensive medication use, and risk of erectile dysfunction in men with type I diabetes. J Hypertens. 2019; 37(5):1070-1076. PMC: 7223638. DOI: 10.1097/HJH.0000000000001988. View

Erden I, Ozhan H, Ordu S, Yalcin S, Caglar O, Kayikci A . The effect of non-dipper pattern of hypertension on erectile dysfunction. Blood Press. 2010; 19(4):249-53. DOI: 10.3109/08037050903576734. View

Fan J, Watanabe T . Atherosclerosis: Known and unknown. Pathol Int. 2022; 72(3):151-160. DOI: 10.1111/pin.13202. View

10.

MacDonald S, Burnett A . Physiology of Erection and Pathophysiology of Erectile Dysfunction. Urol Clin North Am. 2021; 48(4):513-525. DOI: 10.1016/j.ucl.2021.06.009. View

11.

Salles G, Reboldi G, Fagard R, Cardoso C, Pierdomenico S, Verdecchia P . Prognostic Effect of the Nocturnal Blood Pressure Fall in Hypertensive Patients: The Ambulatory Blood Pressure Collaboration in Patients With Hypertension (ABC-H) Meta-Analysis. Hypertension. 2016; 67(4):693-700. DOI: 10.1161/HYPERTENSIONAHA.115.06981. View

12.

Yang W, Melgarejo J, Thijs L, Zhang Z, Boggia J, Wei F . Association of Office and Ambulatory Blood Pressure With Mortality and Cardiovascular Outcomes. JAMA. 2019; 322(5):409-420. PMC: 6822661. DOI: 10.1001/jama.2019.9811. View

13.

Bode-Boger S, Boger R, Kielstein J, Loffler M, Schaffer J, Frolich J . Role of endogenous nitric oxide in circadian blood pressure regulation in healthy humans and in patients with hypertension or atherosclerosis. J Investig Med. 2000; 48(2):125-32. View

14.

Billups K . Erectile dysfunction as an early sign of cardiovascular disease. Int J Impot Res. 2006; 17 Suppl 1:S19-24. DOI: 10.1038/sj.ijir.3901425. View

15.

Boutouyrie P, Bruno R . The Clinical Significance and Application of Vascular Stiffness Measurements. Am J Hypertens. 2018; 32(1):4-11. DOI: 10.1093/ajh/hpy145. View

16.

Diaconu C, Manea M, Marcu D, Socea B, Spinu A, Bratu O . The erectile dysfunction as a marker of cardiovascular disease: a review. Acta Cardiol. 2019; 75(4):286-292. DOI: 10.1080/00015385.2019.1590498. View

17.

Yuvanc E, Dogru M, Simsek V, Kandemir H, Tuglu D . The Effects of Nocturnal Blood Pressure Paterns and Autonomic Alterations on Erectile Functions in Patients with Hypertension. Urol J. 2018; 16(2):198-204. DOI: 10.22037/uj.v0i0.4135. View

18.

Coccina F, Pierdomenico A, Cuccurullo C, Pierdomenico S . Prognostic value of average real variability of systolic blood pressure in elderly treated hypertensive patients. Blood Press Monit. 2019; 24(4):179-184. DOI: 10.1097/MBP.0000000000000381. View

19.

Kinlay S, Creager M, Fukumoto M, Hikita H, Fang J, Selwyn A . Endothelium-derived nitric oxide regulates arterial elasticity in human arteries in vivo. Hypertension. 2001; 38(5):1049-53. DOI: 10.1161/hy1101.095329. View

20.

Safar M, Asmar R, Benetos A, Blacher J, Boutouyrie P, Lacolley P . Interaction Between Hypertension and Arterial Stiffness. Hypertension. 2018; 72(4):796-805. DOI: 10.1161/HYPERTENSIONAHA.118.11212. View