Abstract 18220: Impact of Lipid and Blood Pressure Reduction on Erectile Dysfunction in Persons at Intermediate Risk for Cardiovascular Disease
Introduction: Erectile dysfunction (ED) is associated with cardiovascular disease (CVD) risk factors, and predicts future CVD, suggesting that ED and atherosclerosis share common mechanisms. However, it is unclear whether modifying CVD risk factors improves ED, and there is conflicting data on how pharmacotherapies that modify CVD risk impact ED. We evaluated the impact of pharmacologic cholesterol and blood pressure reduction on ED in men at intermediate CVD risk.
Hypothesis: In patients without CVD but at least 1 CVD risk factor, to determine whether 1) lipid lowering with a statin, 2) blood pressure reduction with candesartan plus hydrochlorothiazide (Cand/HCTZ) and 3) the combination of these pharmacotherapies, impact ED
Methods: Prospective analysis of men in the HOPE-3 randomized control trial. Using a 2x2 factorial design participants were randomized to receive either rosuvastatin (10 mg per day) or placebo, and to Cand/HCTZ (16/12.5 mg per day) or placebo. ED was classified according to the International Index of Erectile Function (IIEF). Participants who completed the IIEF questionnaire at baseline and the end of study follow-up were included. The primary outcome was change in IIEF from baseline to end of study follow-up, which was compared in each treatment group to placebo using the Student’s T-test.
Results: 1974 men completed the IIEF both at baseline and follow-up. The mean age of participants was 61.4 years, and the mean follow-up period was 5.8 years. Mean IIEF score at baseline was 55.4. Treatment with Cand/HCTZ did not result in a significant change in the IIEF when compared to placebo (-2.8 (standard deviation [SD] 11.9) vs. -1.9 (SD 11.9), p = 0.09). Change in IIEF was also similar with rosuvastatin treatment compared to placebo (-2.1 [11.8] vs. -2.5 [11.9], p=0.44). Treatment with both rosuvastatin and Cand/HCTZ did not significantly change the IIEF when compared to double-placebo (-2.4 [SD 11.7] vs. -1.9 [SD 11.8], p = 0.49). The impact of each treatment on erectile function did not vary by severity of baseline ED symptoms.
Conclusions: Pharmacologic reduction of cholesterol and blood pressure, either alone or in combination, does not impact ED symptoms. Importantly, statins and Cand/HCTZ do not adversely impact erectile function.
Author Disclosures: P. Joseph: None. E. Lonn: Research Grant; Significant; Research Funding AstraZenaca. J. Bosch: None. S. Balakumar: None. S. Yusuf: Research Grant; Significant; Research Funding AstraZenaca.
- © 2016 by American Heart Association, Inc.