Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Assessment of cavernosal perfusion in men with erectile dysfunction (ED) relies on Doppler spectrum analysis of pharmachologically stimulated peak systolic velocity (sPSV) in cavernous arteries but its accuracy in identifying men affected by a cavernosal perfusion disorder correlated with atherosclerosis remains undefined. We estimated by B-mode ultrasound, the accuracy of sPSV of cavernous arteries to identify ED with an expected cavernosal perfusion disorder. This was predicted by an elevated intima-media thickness (IMT) of common carotid arteries, a reference methodology to estimate the degree of generalized atherosclerosis, in men exposed to vascular risk factors (VRFs). sPSV and IMT were evaluated in 269 men with ED, 49 had no VRFs, 100 were overweight with/or without hyperlipidaemia, 120 were affected by type 2 diabetes and/or essential hypertension. sPSV was significantly lower (p<0.05) in patients with VRFs associated with atherosclerosis (IMT>or=1 mm) (n=39) than in men with no VRFs and no atherosclerosis (n=49). sPSV correlated negatively with age (p<0.0001), with serum% of glycated haemoglobin (p=0.010) and with carotid artery IMT (p=0.013). An sPSV<or=30 cm/sec, the cut-off value which showed at receiver operating characteristic curve analysis the combined highest value of sensitivity and specificity, correctly identified only 57% of men in whom a cavernosal perfusion disorder was expected based on the presence of carotid artery IMT>or=1 mm combined to the exposure to VRFs. The ultrasonographic evaluation of sPSV had a very limited accuracy in discriminating ED with an expected cavernosal perfusion disorder, based on the presence of a generalized atherosclerosis in men with VRFs.
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PMID:Penile duplex pharmaco-ultrasonography of cavernous arteries in men with erectile dysfunction and generalized atherosclerosis. 1720 82

Hyperlipidemia is one of the risk factors leading to erectile dysfunction (ED), a common disorder in men, especially in old men. Epidemiological studies have found that the decrease in high density lipoprotein (HDL) and elevation of total cholesterol/high density lipoprotein (TC/HDL) are correlated with ED. Studies have also shown that arterial stenosis and occlusion caused by hyperlipidemia could be attributed to the advanced-stage mechanism of ED induced by hyperlipidemia. Hyperlipidemia may damage man's erectile function at an early stage by affecting the endothelial cells and smooth muscles of the penis and the peripheral nerves for penile erection. Apart from dietary therapy and drug therapy aiming at hyperlipidemia, the traditional Chinese medicine therapy and gene therapy are two promising approaches to the treatment of ED caused by hyperlipidemia.
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PMID:[Hyperlipidemia and erectile dysfunction]. 1689 47

Erectile dysfunction (ED) has been linked increasingly to cardiovascular risk factors and comorbidities. Considering the potential risk associated with sexual activity, guidelines were developed (Princeton I) for assessment and management of patients with varying degrees of cardiac risk. These guidelines were recently updated (Princeton II) based on new data concerning the link between ED and cardiovascular disease and the availability of additional phosphodiesterase type 5 inhibitors (vardenafil, tadalafil). Despite the need for careful risk assessment in all cases, sexual activity remains safe for the large majority of patients. However, all patients presenting with complaints of ED should be carefully assessed for the presence of cardiovascular risk factors (eg, obesity, hypertension, hyperlipidemia). Risk-factor modification, including lifestyle interventions (eg, exercise, weight loss) is strongly encouraged. Guidelines are presented for the management of acute coronary syndromes in patients taking phosphodiesterase type 5 inhibitors, including alternatives to the use of nitrates for these patients. Other drug interactions and the cardiovascular safety of testosterone replacement therapy are considered.
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PMID:Erectile dysfunction and cardiac disease: recommendations of the Second Princeton Conference. 1705 47

Erectile dysfunction (ED) is a common condition with a significant effect on quality of life. The prevalence of ED increases with age and other risk factors (hypertension, diabetes, smoking, coronary heart disease, dyslipidemia and depression). Nitric oxide (NO) activity is adversely affected, in penile and vascular tissue, by these risk factors. Endothelial dysfunction and a reduced generation or bioavailability of NO have emerged as major pathophysiological mechanisms in ED. Hyperlipidemia may impair erectile function by affecting endothelial and smooth muscle cells of the penis. Oxidized low-density lipoprotein is a causative factor for the impaired relaxation response of the corpus cavernosum. Elevated serum cholesterol and reduced high density lipoprotein cholesterol levels are associated with an increased risk of ED. It follows that treating dyslipidemia could have a beneficial effect on ED. Phosphodiesterase type 5 inhibitors are now considered as first line treatment for ED. There is evidence that statins improve responses to these drugs. ED is considered as a warning sign of silent or early vascular disease. The use of statins may be beneficial in these patients.
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PMID:Dyslipidemia as a risk factor for erectile dysfunction. 1762 14

Cardiovascular diseases like hypertension, hyperlipidemia, diabetes mellitus and obesity are the important predictors of erectile dysfunction (ED). Endothelial dysfunction is proposed to be the underlying cause of ED, just like coronary artery disease. Sildenafil was originally developed to treat angina pectoris but later on was recognized as novel treatment option for impotence. To date, sildenafil has been the most extensively studied PDE (phosphodiesterase)-5 inhibitor. Currently two more PDE-5 inhibitors, tadalafil and vardenafil, are under study. Newer compounds have certain advantages over sildenafil, including greater selectivity for PDE-5 compared with other isoenzymes, absence of effect of food on absorption, faster onset and longer duration of action. PDE-5 inhibitors are emerging as novel therapeutic tools with a potential to protect or enhance endothelial function in humans and to selectively improve regional blood flow. The FDA has recently approved a reformulation of sildenafil for the treatment of pulmonary arterial hypertension. Raynaud's phenomenon, respiratory disorders with ventilation/ perfusion mismatch, congestive cardiac failure, hypertension and stroke are the other conditions in which PDE-5 inhibitors are being tried. It is hoped that this group of drugs will soon emerge as a novel weapon in the armamentarium against various cardiovascular and pulmonary diseases.
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PMID:Novel phosphodiesterase-5 inhibitors: current indications and future directions. 1817 38

There is increased awareness regarding the close association between cardiovascular disease and erectile dysfunction, especially because both conditions share common risk factors such as diabetes mellitus, hypertension, smoking, hyperlipidemia, and a sedentary lifestyle. Recent studies suggest that erectile dysfunction could be considered a potential marker for underlying silent cardiac or vascular disease processes. Endothelial dysfunction seems to play a major role in both sexual dysfunction and heart disease. With the initiation in 1998 of vasoactive drugs such as the phosphodiesterase-5 inhibitors for the treatment of erectile dysfunction, the underlying vascular components of erectile dysfunction have become a more prominent focus of attention in the clinical and research setting. This review critically examines the background, pathophysiology, and mechanisms behind erectile dysfunction and its close correlation to cardiovascular disease.
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PMID:The relationship between erectile dysfunction and cardiovascular disease. Part I: pathophysiology and mechanisms. 1819 44

Age-related decline in serum testosterone and dehydroepiandrosterone sulfate concentrations occur in men. Low concentrations of these endogenous androgens have been linked with insulin resistance, which is an important upstream driver for metabolic abnormalities such as hyperglycemia, hypertension, or hyperlipidemia, and increased cardiovascular risk. Moreover, men with diabetes have significantly less circulating androgen than nondiabetic men. Here, we summarize how androgen affects insulin resistance and atherosclerosis in men with type 2 diabetes. Low serum concentrations of endogenous androgens are associated with visceral fat accumulation. Androgen deprivation by castration to treat prostate cancer increases insulin resistance, while testosterone administration in type 2 diabetic men with androgen deficiency improves glucose homeostasis and decreases visceral fat, in addition to alleviating symptoms of androgen deficiency including erectile dysfunction. Androgen correlates inversely with severity of atherosclerosis and has beneficial effects upon vascular reactivity, inflammatory cytokine, adhesion molecules, insulin resistance, serum lipids, and hemostatic factors. Because men with type 2 diabetes have relative hypogonadism, testosterone supplementation could decrease both insulin resistance and atherosclerosis.
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PMID:Role of endogenous androgen against insulin resistance and athero- sclerosis in men with type 2 diabetes. 1822 Jun 53

Because sildenafil citrate is a treatment, not a cure, for erectile dysfunction (ED), many men may choose to use it for an extended period. Men with ED who had previously completed 1 of 4 double-blind trials with short-term open-label extension (combined duration, 0.9-1.2 years) were eligible for this 4-year, open-label, extension study, which assessed the safety and effectiveness of flexible doses (25, 50, and 100 mg sildenafil) used as needed. Adverse events that were serious or led to dosing changes or discontinuation (temporary or permanent) were recorded. Many of the 979 participants (mean age, 58 [range, 27-82] years; mean ED duration, 4.5 years) had concomitant hypertension (28%), diabetes (22%), or hyperlipidemia (14%). Overall, 37 (3.8%) had treatment-related adverse events (none serious) requiring dosage change or discontinuation and 62 (6.3%) discontinued because of insufficient response. At each yearly assessment, more than 94% of participants responded affirmatively to the questions: "Are you satisfied with the effect of treatment on your erections?" and "If yes, has treatment improved your ability to engage in sexual activity?" These results argue against the loss of tolerability or the development of tachyphylaxis over a prolonged period of as needed, flexible-dose sildenafil treatment of men with ED.
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PMID:Long-term safety and effectiveness of sildenafil citrate in men with erectile dysfunction. 1851 12

Erectile dysfunction (ED) is a common disease in men, especially in old men, the mechanisms of which have yet to be further investigated. Accumulating evidence indicates that one important mechanism of ED is the excessive apoptosis of erectile tissues, which can be caused by a lot of risk factors of ED and thereby reduce penile erectile function. This paper reviews the mechanisms of cell apoptosis, the role of apoptosis in ED, the relationship between apoptosis and the risk factors of ED, such as diabetes mellitus, hyperlipidemia, cavernous nerve injury and aging.
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PMID:[Cell apoptosis and male erectile dysfunction]. 1915 38

Erectile dysfunction (ED) is the inability to attain and/ or maintain an erection sufficient for satisfactory sexual performance. The prevalence of ED among elderly men is 52%, and it is associated with preventable and treatable cardiovascular conditions, such as diabetes mellitus, hyperlipidemia, hypertension and smoking. Treating these conditions may prevent cardiovascular diseases and ED. Nevertheless, large-scale studies regarding the prevalence of ED among young men has never been conducted, although prevention should be performed in younger ages. A unique screening examination, including a sexual questionnaire has been conducted in Israel since 2001. Men who are suspected of ED, according to this questionnaire, are referred to a sexual clinic for consultation and treatment. In this review, we present several studies based on this database. Our main findings: ED is prevalent in young men and is associated with diabetes mellitus, hypertriglyceridemia, sleeping disorders and periodontal diseases. These findings stress the importance of incorporating a sexual questionnaire in screening examinations.
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PMID:[Incorporating a sexual questionnaire in screening examinations]. 2007 58


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