TY - JOUR
T1 - Heart rate and blood pressure interactions in the development of erectile dysfunction in high-risk cardiovascular patients
AU - Kratz, Mario T.
AU - Schumacher, Helmut
AU - Sliwa, Karen
AU - Schmieder, Roland
AU - Poess, Janine
AU - Mahfoud, Felix
AU - Unger, Thomas
AU - Lonn, Eva
AU - Koon, Teo
AU - Mancia, Guiseppe
AU - Sleight, Peter
AU - Yusuf, Salim
AU - Boehm, Michael
PY - 2014/3
Y1 - 2014/3
N2 - Aims Erectile dysfunction (ED) is associated with cardiovascular risk factors as elevated systolic blood pressure (SBP), resting high heart rate (HR), and endothelial dysfunction and predicts cardiovascular events. However, the interaction between high HR and SBP and the development of ED remains unclear. Methods and Results We evaluated 1015 male patients enrolled in the ED substudy of ONTARGET and TRANSCEND, examining the influence of mean HR and mean SBP obtained over all study visits (mean 10.91.4 study visits) and their interaction with ED. In patients without pre-existing ED, new onset ED was detected in 29% of patients below, and 41% of patients above, the median of mean HR (OR 1.72, 95% CI 1.8-2.5, p=0.0047). In patients with pre-existing ED, high HR had no add-on effect. With or without pre-existing ED, high SBP had no influence after adjustment for covariates (OR 1.03, 95% CI 0.66-1.59, p=0.91). In a continuous model, it was shown that effects of high HR were prominent at low Kolner (Cologne) Evaluation of Erectile Function (KEED) score baseline values and in the presence of SBP above the median. Conclusions In patients at risk for cardiovascular events, high HR is associated with ED, whereas the effect of high SBP was not significant. High resting HR might represent a cardiovascular risk indicator. Whether HR represents a potential treatment target to improve ED in high-risk individuals must be scrutinized in prospective trials.
AB - Aims Erectile dysfunction (ED) is associated with cardiovascular risk factors as elevated systolic blood pressure (SBP), resting high heart rate (HR), and endothelial dysfunction and predicts cardiovascular events. However, the interaction between high HR and SBP and the development of ED remains unclear. Methods and Results We evaluated 1015 male patients enrolled in the ED substudy of ONTARGET and TRANSCEND, examining the influence of mean HR and mean SBP obtained over all study visits (mean 10.91.4 study visits) and their interaction with ED. In patients without pre-existing ED, new onset ED was detected in 29% of patients below, and 41% of patients above, the median of mean HR (OR 1.72, 95% CI 1.8-2.5, p=0.0047). In patients with pre-existing ED, high HR had no add-on effect. With or without pre-existing ED, high SBP had no influence after adjustment for covariates (OR 1.03, 95% CI 0.66-1.59, p=0.91). In a continuous model, it was shown that effects of high HR were prominent at low Kolner (Cologne) Evaluation of Erectile Function (KEED) score baseline values and in the presence of SBP above the median. Conclusions In patients at risk for cardiovascular events, high HR is associated with ED, whereas the effect of high SBP was not significant. High resting HR might represent a cardiovascular risk indicator. Whether HR represents a potential treatment target to improve ED in high-risk individuals must be scrutinized in prospective trials.
KW - Endothelial dysfunction
KW - endothelial function
KW - heart rate
KW - high cardiovascular risk
U2 - 10.1177/2047487313494835
DO - 10.1177/2047487313494835
M3 - Article
C2 - 23818288
SN - 2047-4873
VL - 21
SP - 272
EP - 280
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 3
ER -