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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An animal model was developed to study the pathophysiology of erectile dysfunction due to atherosclerotic vascular disease. Thirty one New Zealand white male rabbits were divided into control (n = 5) and treatment groups (n = 26). The control group was placed on a regular diet while the treatment group underwent balloon de-endothelialization of the aorto-iliac arteries and received 1.6% cholesterol and 4% triglyceride diet for eight weeks. After eight weeks in the control animals (n = 5), blood levels of cholesterol, triglycerides and low density lipoproteins, radiologic studies as well as hemodynamic parameters of erectile function were all normal. In the surviving treatment animals (n = 21) after the same time period, a significant increase in blood levels of cholesterol, triglyceride and low density lipoprotein were observed. In addition, 62% of these animals developed hypertension which was not observed in the control group. Angiographically, 10 animals (48%) demonstrated severe atherosclerotic lesions (75% to 100% occlusion of common or internal iliac arteries on one side and over 50% occlusion of the opposite side), five (24%) had moderate lesions (50 to 75% luminal occlusion of right and left common iliac or internal iliac arteries) and 6 revealed minimal lesions (less than 50% occlusion of the right and left common iliac or internal iliac arteries). Of the 15 animals with 50% or greater luminal occlusion of the iliohypogastric arteries, erectile dysfunction was found in 93% of cases. Due to the development of erectile dysfunction in 33% of animals with minimal occlusive lesions, it appears that factors, other than large vessel luminal occlusion, may exist in this animal model which adversely influence erectile function. This model may therefore be of further benefit in the study of other factors associated with atherosclerosis and impotence, such as the possible concomitant hypercholesterolemic and atherosclerotic-induced alterations in the local reactivity of corpus cavernosum smooth muscle and lacunar space endothelial cells.
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PMID:Erectile dysfunction due to atherosclerotic vascular disease: the development of an animal model. 159 19

The present study was undertaken in 223 male patients who had consulted for erectile dysfunction. Patient failure to obtain spontaneous erection on waking was a prerequisite for inclusion in the study. The mean patient age was 50.82 years. The penile brachial pressure index (PBI) was determined by Doppler stethoscopy in all patients; 194 patients had a mean PBI of 0.79%. We evaluated 197 patients for the following arterial risk factors: smoking habit, hyperlipidemia, arterial hypertension, and diabetes mellitus. The results showed 148 were smokers; of these, 40 (28.6%) had no other arterial risk factor. Ninety-five had hyperlipidemia; of these, 19 (20%) had no other arterial risk factor. Hypertension was the only arterial risk factor in 8 (10%) of 73 hypertensives. Diabetes was the only arterial risk factor in 2 (6.4%) of the 31 with this condition. The mean age of patients with no arterial risk factors was 42.64 years. The number of risk factors increased with mean patient age. Three or more risk factors were observed in the patient group with a mean age of 57 years. The PBI dropped as the number of arterial risk factors rose. Patients with no arterial risk factors had a PBI of 0.83 whereas patients with three or more arterial risk factors had a PBI of 0.75. No statistical significance was observed when the arterial risk factors were combined.
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PMID:[Arterial risk factors in sexual impotence]. 262 92

To explore how hypertension affects penile erection, we studied erectile hemodynamics during nocturnal penile tumescence in 3 groups of middle-aged men: hypertensive patients with and without erectile dysfunction, and normotensive controls without erectile problems. The hypertensive patients were not taking antihypertensive medication. Evaluations included standard monitoring of penile circumference change as well as noninvasive monitoring of penile segmental pulsatile blood flow and activity in the bulbocavernosus-ischiocavernosus muscles. Variables differed in how they discriminated among groups. Median amplitude of penile blood flow during rapid eye movement sleep differed significantly among all 3 study groups: controls had the highest amplitudes, patients without erectile problems had lower values and patients with erectile complaints had the lowest values. By contrast, standard measures of nocturnal penile tumescence (that is based on penile circumference change during sleep) only distinguished the patients with erectile problems from the 2 other groups. Density of musculovascular event clusters during rapid eye movement sleep (nearly simultaneous muscle activity burst, blood flow burst and circumference pulsation) distinguished the 2 groups of hypertensive men from controls. The sensitivity of the blood flow measure to changes in the hypertensive men without erectile complaints may indicate that the measure can reveal subclinical signs of developing vasculogenic erectile dysfunction.
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PMID:Erectile dysfunction in hypertensive men: sleep-related erections, penile blood flow and musculovascular events. 273 10

Sleep-related respiratory pattern was evaluated in 175 hypertensive and 110 normotensive men, none of whom reported difficulties in initiating or maintaining sleep. Patients were grouped according to sexual status (complaint of erectile problems), hypertension treatment status (treated or untreated), and blood pressure (diastolic less than 90 or greater than or equal to 90). The prevalence of sleep apnea, apnea index, duration of the longest episode of apnea, and penile rigidity were tabulated. The group with elevated blood pressure, persistent even with antihypertensive drug therapy, had the most sleep apnea. The treated hypertensive men with controlled blood pressure had significantly less apnea than those whose blood pressure remained high. Untreated hypertensive groups, however, did not differ from normotensive groups with respect to apnea. Evidence of abnormal sleep-related respiratory activity was found in both hypertensive and normotensive groups with erectile problems. Interestingly, penile rigidity was significantly lower for hypertensive men with erectile complaints than for normotensive men with erectile complaints. There was also a small, but significant, negative correlation between apnea index and penile rigidity among men with erectile complaints. These results indicate that sexual status is an important consideration in the diagnosis of hypertension and sleep apnea. Moreover, these data suggest an interrelationship among hypertension, erectile dysfunction, and sleep apnea.
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PMID:Hypertension, erectile dysfunction, and occult sleep apnea. 274 Jun 93

Sexual dysfunction was studied in 50 patients who had had a myocardial infarction (MI) matched with 50 control patients who were comparable in terms of age, hypertension, diabetes, and smoking. The MI group revealed sexual dysfunction in 76%, with erectile dysfunction in 42%. In the control group there was sexual dysfunction in 68% and erectile dysfunction in 48%. There was no statistically significant difference observed between the two groups. However, there was a significant influence of sex counseling on subsequent sexual functioning. Patients who received information as to when it was safe for them to resume sexual activity showed a lesser degree of apprehension in the post-MI period. The need of sexual rehabilitation for these patients and more thorough epidemiological comparative studies are suggested.
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PMID:Myocardial infarction and its influence on male sexual function. 380 Jun 40

Careful evaluation was carried out in 93 men older than 50 with erectile dysfunction. Their mean age was 61 years and the disorder had been present for a mean of 4.5 years. While 14 men (15%) had psychosocial factors that may have been pertinent, only 2 scored poorly on an Affect Balance Scale and 3 were receiving psychoactive medications. Results of nocturnal penile tumescence were abnormal in 91%. In 39% penile-brachial pressure indices were suggestive of pelvic vascular disease and in 9% were consistent with a pelvic "steal syndrome." Pelvic or peripheral nerve conduction disorders were also commonly seen in 54%. Endocrinopathy may have contributed to the dysfunction in 35%. Twenty-one men had diabetes mellitus, two new cases of hypothyroidism were discovered and hypogonadism was diagnosed definitely in four and considered likely in five others. Coexisting medical conditions were found in more than 90% of the men, especially hypertension, use of antihypertensive medications and atherosclerotic disease. Previous prostatectomies (19%) and vasectomies (30%) were common in the surgical histories. Given the wide range of disorders uncovered in older men complaining of impotence, diagnostic study of potential causes may lead to a more rational approach for the evaluation and management of these men.
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PMID:Evaluation of impotence in older men. 401 64

By direct interrogation and specific questions, the erectile function of 1,128 male adults, aged sixteen to eighty years and over, was elicited. The erectile function was based on ability to develop an erectile angle of 90 degrees and more, and this was used for classification purposes. Three hundred seventeen consecutive, unselected male diabetics and 117 nondiabetic male hypertensives were compared with 635 consecutive adult males with neither diabetes nor hypertension. Our results indicate that erectile dysfunction, partial or complete, is more prevalent in diabetics compared with nondiabetics of the same age groups. An unexpected finding was a meager relationship between hypertension and erectile disability. Antihypertensive drugs were responsible for only 2 cases of erectile dysfunction in our male hypertensive patients. The negative impact of age was noted in all age groups and in those with or without diabetes or hypertension.
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PMID:Erectile dysfunction in diabetes and hypertension. 402 3

The parameters of the functional evaluation of the penile arterial system in sexually active males are based on a minimal number of volunteers and impotent patients of neurogenic origin who are expected to have a normal vascular system. In order to investigate these parameters in 23 sexually active diabetic and nondiabetic males, penile arterial systems were evaluated by color Doppler ultrasonography. Parameters obtained from the cavernous arteries were arterial diameter (pre- and postpapaverine), diameter increase rate and systolic peak blood flow velocity. Systolic peak blood flow velocities in papaverine-induced erection were 36.75 (+/- 9.99) and 37.50 (+/- 13.18) cm/s for right and left cavernosal arteries, respectively, in nondiabetic 16 men. The mean cavernosal artery diameter changes were 89.23 and 77.93% for right and left cavernosal arteries. Systolic peak blood flow velocities were 24.57 (+/- 7.44) and 25.42 (+/- 9.45) cm/s and diameter increase rates were 78.57 and 37.50% for right and left cavernosal arteries in diabetic sexually active men. Sexually active diabetics have a significantly lower cavernosal artery peak blood flow velocity and diameter increase rate than nondiabetics (p < 0.01). Thus a subclinic dysfunction of erection might be introduced in diabetic males. In conclusion, each investigator should determine his own standards on sexually active subjects and on those with different etiologies such as diabetics mellitus, hypertension and hypercholesterolemia, contributing to erectile dysfunction.
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PMID:Evaluation of penile arterial system with color Doppler ultrasonography in nondiabetic and diabetic males. 765 8

Erectile dysfunction is more common than previously thought in men older than 40 years, perhaps because contributing medical risk factors increase with age. The medical history is of prime importance in outlining these factors, the most common of which are diabetes, hypertension, and smoking. Nocturnal penile tumescence and rigidity testing with a portable home monitor may be helpful in determining whether the cause of erectile dysfunction is primarily organic or psychological. Specific therapeutic measures include sex therapy, psychotherapy, treatment for alcohol or tobacco dependency, replacement of offending medications, improved glycemic control, constriction rings, vascular surgery, androgen replacement therapy, bromocriptine mesylate (Parlodel), and thyroid, adrenal, or pituitary replacement therapy. Nonspecific therapies include yohimbine hydrochloride (Yocon), use of vacuum tumescence devices, intracorporeal injections, and penile implants.
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PMID:Erectile dysfunction. Are you prepared to discuss it? 771 86

The treatment of arteriogenic erectile dysfunction with revascularization techniques has been controversial both in terms of its use and the type of surgical repair. Success rates reported in the literature are based almost exclusively on patient testimonial, without the use of objective post-operative criteria. At our institution from 7/88 through 8/91, 18 patients were treated for arteriogenic impotence using microsurgical penile revascularization. The patient population ranged in age from 23 to 64 years, and each patient underwent a complete history and physical examination, serum hormone testing, psychological evaluation of patient and partner, biothesiometry, penile plethysmography, nocturnal penile tumescence/rigidity testing with a Rigiscan device, and selective pudendal arteriography. One patient was status post a pelvic fracture, 2 lacked identifiable risk factors, 2 had diabetes, 6 were heavy smokers, and 7 had hypertension. Pre-operatively each patient had a suspicious medical history, abnormal plethysmography, abnormal Rigiscan testing, and a hemodynamically significant lesion on angiography. Revascularization was done by anastomosing the inferior epigastric artery to the deep dorsal veing and dorsal artery, or the deep dorsal vein alone if both arteries were atretic. Postoperatively, all 18 patients underwent a personal interview, repeat penile plethysmography, and repeat Rigiscan testing. Six patients reports successful coitus and an additional four were having coitus with the aid of intracavernous pharmacotherapy. Seventy-eight percent (14/18) had improved tracings on penile plethysmography, and 56% (10/18) had normal erectile capability by Rigiscan testing.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The success of microsurgical penile revascularization in treating arteriogenic impotence. 834 13


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