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Kulecki M, Naskret D, Kaminski M, Kasprzak D, Lachowski P, Klause D, Kozlowska M, Flotynska J, Uruska A, Zozulinska-Ziolkiewicz D. Arterial stiffness and the non-dipping pattern in type 1 diabetes males with and without erectile dysfunction. Sci Rep 2023; 13:7265. [PMID: 37142663 PMCID: PMC10160017 DOI: 10.1038/s41598-023-33315-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/11/2023] [Indexed: 05/06/2023] Open
Abstract
Arterial stiffness (AS) and non-dipping pattern are early predictors of cardiovascular diseases but are not used in clinical practice. We aimed to assess if AS and the non-dipping pattern are more prevalent in the erectile dysfunction (ED) group than in the non-ED group among subjects with type 1 diabetes (T1DM). The study group consisted of adults with T1DM. Aortic pulse wave velocity (PWV Ao)-a marker of increased AS, central systolic blood pressure, and heart rate (HR) were measured with a brachial oscillometric device (Arteriograph 24). Erectile dysfunction (ED) was assessed by the International Index of Erectile Function-5. A comparison between the groups with and without ED was performed. Of 34 investigated men with T1DM, 12 (35.3%) suffered from ED. The group with ED had higher mean 24 h HR (77.7 [73.7-86.5] vs 69.9 [64.0-76.8]/min; p = 0.04, nighttime PWV Ao (8.1 [6.8-8.5] vs 6.8 [6.1-7.5] m/s; p = 0.015) and prevalence of non-dipping SBP Ao pattern (11 [91.7] vs 12 [54.5]%; p = 0.027) than individuals without ED. The presence of ED detected a central non-dipping pattern with a sensitivity of 47.8% and a specificity of 90.9%. The central non-dipping pattern was more prevalent and the nighttime PWV was higher in T1DM subjects with ED than in those without ED.
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Affiliation(s)
- Michał Kulecki
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland.
| | - Dariusz Naskret
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Mikolaj Kaminski
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Dominika Kasprzak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Pawel Lachowski
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Daria Klause
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Maria Kozlowska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Justyna Flotynska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Aleksandra Uruska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Dorota Zozulinska-Ziolkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
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Yildirim U, Karakayali M, Uslu M, Ezer M, Erihan IB, Artac I, Omar T, Karabag Y, Rencuzogullari I. Association between international index of erectile function-5 scores and circadian patterns of newly diagnosed hypertension in erectile dysfunction patients. Andrologia 2022; 54:e14622. [PMID: 36271752 DOI: 10.1111/and.14622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/17/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022] Open
Abstract
By the beginning of this study in 2019, it was known that hypertension is a risk factor for erectile dysfunction, and also, there are circadian changes that occur in blood pressure. Further, non-dipping hypertension is known to be linked to poor cardiac outcomes and erectile functions, so the research described in this article was initiated with an aim to explore the potential relationship between erectile dysfunction and circadian patterns of newly diagnosed hypertension. Between April 2019 and May 2022, 583 patients aged 30-70 years were diagnosed with erectile dysfunction (ED) in our outpatient clinic. Applying our exclusion criteria to 583 patients, a group of 371 patients left with us; these patients were referred to the cardiology clinic for hypertension evaluation with consecutive ambulatory blood pressure monitoring (ABPM). Data were collected for the study prospectively. Of the 371 patients evaluated with ABPM, 125 had newly diagnosed hypertension (mean BP ≥135/85 mmHg in ABPM). These patients were divided into two groups according to the pattern of hypertension identified in ABPM: dippers (Group D) and non-dippers (Group ND). They were then compared using clinical and laboratory findings, including erectile function scores. While the number of patients in the ND group was 83, the number in the D group was 42. In the ND group, the mean age was higher (59 ± 10 vs. 54 ± 12, p = 0.0024). IIEF-5 (international index of erectile function) scores were determined to be significantly lower in the ND group (14.4 ± 4.9 vs. 11.5 ± 4.6, p = 0.001). Also, serum creatinine levels were higher in Group ND than in D (0.96 ± 0.12 vs. 1 ± 0.15, p = 0.001). In our multivariate analysis, IIEF-5 scores (OR: 0.880, 95% CI: 0.811-0.955; p = 0.002) and serum creatinine levels (OR: 1027, 95% CI: 1003-1052; p = 0.025) were found to be independent risk factors of non-dipper HT. The cut-off value of the IIEF-5 score for non-dipper HT in a ROC curve analysis was 13.5 with 64.3% sensitivity and 66.1% specificity (area under curve value: 0.673 [95% CI: 0.573-0.772, p < 0.001]). This study showed that, in patients with ED, the non-dipper pattern was associated with poorer erectile function when HT was newly diagnosed. We also found that the severity of erectile dysfunction is an independent marker for non-dipper HT.
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Affiliation(s)
- Umit Yildirim
- Department of Urology, M.D. Kafkas University School of Medicine, Kars, Turkey
| | - Muammer Karakayali
- Department of Cardiology, M.D. Kafkas University School of Medicine, Kars, Turkey
| | - Mehmet Uslu
- Department of Urology, M.D. Kafkas University School of Medicine, Kars, Turkey
| | - Mehmet Ezer
- Department of Urology, M.D. Kafkas University School of Medicine, Kars, Turkey
| | - Ismet Bilger Erihan
- Department of Urology, M.D. Kafkas University School of Medicine, Kars, Turkey
| | - Inanc Artac
- Department of Cardiology, M.D. Kafkas University School of Medicine, Kars, Turkey
| | - Timor Omar
- Department of Cardiology, M.D. Kafkas University School of Medicine, Kars, Turkey
| | - Yavuz Karabag
- Department of Cardiology, M.D. Kafkas University School of Medicine, Kars, Turkey
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Kakkavas A, Tsioufis C, Tsiachris D, Thomopoulos C, Dimitriadis K, Milkas A, Alexopoulos D, Kallikazaros I, Stefanadis C. Erectile Dysfunction and Target Organ Damage in the Early Stages of Hypertension. J Clin Hypertens (Greenwich) 2013; 15:644-9. [DOI: 10.1111/jch.12159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 05/17/2013] [Accepted: 05/21/2013] [Indexed: 11/27/2022]
Affiliation(s)
| | - Costas Tsioufis
- First Cardiology Clinic; Hippocration Hospital; University of Athens Medical School; Athens Greece
| | - Dimitris Tsiachris
- First Cardiology Clinic; Hippocration Hospital; University of Athens Medical School; Athens Greece
| | - Costas Thomopoulos
- First Cardiology Clinic; Hippocration Hospital; University of Athens Medical School; Athens Greece
| | - Kyriakos Dimitriadis
- First Cardiology Clinic; Hippocration Hospital; University of Athens Medical School; Athens Greece
| | - Anastasios Milkas
- First Cardiology Clinic; Hippocration Hospital; University of Athens Medical School; Athens Greece
| | | | | | - Christodoulos Stefanadis
- First Cardiology Clinic; Hippocration Hospital; University of Athens Medical School; Athens Greece
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Javaroni V, Neves MF. Erectile dysfunction and hypertension: impact on cardiovascular risk and treatment. Int J Hypertens 2012; 2012:627278. [PMID: 22649713 PMCID: PMC3357516 DOI: 10.1155/2012/627278] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 02/15/2012] [Accepted: 02/24/2012] [Indexed: 01/29/2023] Open
Abstract
Erectile dysfunction (ED) is a common complaint in hypertensive men and can represent a systemic vascular disease, an adverse effect of antihypertensive medication or a frequent concern that may impair drug compliance. ED has been considered an early marker of cardiovascular disease. The connection between both conditions seems to be located in the endothelium, which may become unable to generate the necessary dilatation in penile vascular bed in response to sexual excitement, producing persistent impairment in erection. On the other hand, the real influence of antihypertensive drugs in erectile function still deserves discussion. Therefore, regardless of ED mechanism in hypertension, early diagnosis and correct approach of sexual life represent an important step of cardiovascular evaluation which certainly contributes for a better choice of hypertension treatment, preventing some complications and restoring the quality of life.
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Affiliation(s)
- Valter Javaroni
- Department of Clinical Medicine, State University of Rio de Janeiro, 20551030 Rio de Janeiro, RJ, Brazil
- Departamento de Clínica Médica, Hospital Universitário Pedro Ernesto, Rua Vinte e Oito de Setembro, 77 sala 329, Vila Isabel, 20551030 Rio de Janeiro, RJ, Brazil
| | - Mario Fritsch Neves
- Department of Clinical Medicine, State University of Rio de Janeiro, 20551030 Rio de Janeiro, RJ, Brazil
- Departamento de Clínica Médica, Hospital Universitário Pedro Ernesto, Rua Vinte e Oito de Setembro, 77 sala 329, Vila Isabel, 20551030 Rio de Janeiro, RJ, Brazil
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Foocharoen C, Tyndall A, Hachulla E, Rosato E, Allanore Y, Farge-Bancel D, Caramaschi P, Airó P, Nikolaevna SM, Pereira da Silva JA, Stamenkovic B, Riemekasten G, Rednic S, Sibilia J, Wiland P, Tarner I, Smith V, Onken AT, Abdel Atty Mohamed WA, Distler O, Morović-Vergles J, Himsel A, de la Peña Lefebvre PG, Hügle T, Walker UA. Erectile dysfunction is frequent in systemic sclerosis and associated with severe disease: a study of the EULAR Scleroderma Trial and Research group. Arthritis Res Ther 2012; 14:R37. [PMID: 22348608 PMCID: PMC3392836 DOI: 10.1186/ar3748] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Revised: 12/11/2011] [Accepted: 02/20/2012] [Indexed: 02/05/2023] Open
Abstract
Introduction Erectile dysfunction (ED) is common in men with systemic sclerosis (SSc) but the demographics, risk factors and treatment coverage for ED are not well known. Method This study was carried out prospectively in the multinational EULAR Scleroderma Trial and Research database by amending the electronic data-entry system with the International Index of Erectile Function-5 and items related to ED risk factors and treatment. Centres participating in this EULAR Scleroderma Trial and Research substudy were asked to recruit patients consecutively. Results Of the 130 men studied, only 23 (17.7%) had a normal International Index of Erectile Function-5 score. Thirty-eight per cent of all participants had severe ED (International Index of Erectile Function-5 score ≤ 7). Men with ED were significantly older than subjects without ED (54.8 years vs. 43.3 years, P < 0.001) and more frequently had simultaneous non-SSc-related risk factors such as alcohol consumption. In 82% of SSc patients, the onset of ED was after the manifestation of the first non-Raynaud's symptom (median delay 4.1 years). ED was associated with severe cutaneous, muscular or renal involvement of SSc, elevated pulmonary pressures and restrictive lung disease. ED was treated in only 27.8% of men. The most common treatment was sildenafil, whose efficacy is not established in ED of SSc patients. Conclusions Severe ED is a common and early problem in men with SSc. Physicians should address modifiable risk factors actively. More research into the pathophysiology, longitudinal development, treatment and psychosocial impact of ED is needed.
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Affiliation(s)
- Chingching Foocharoen
- Department of Rheumatology, Basel University, Burgfelderstrasse 101, Basel 4012, Switzerland
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