title: Brachial flow-mediated dilation correlates with vardenafil response in hypertensive men with vasculogenic erectile dysfunction.
abstract: OBJECTIVE
  To investigate whether vasculogenic erectile dysfunction (ED) severity and the clinical response to vardenafil were associated with structural and functional vascular changes in patients with uncomplicated hypertension.
  
  
  METHODS
  Sexually active hypertensive men (n = 100), aged 50-70 years, completed the International Index of Erectile Function, Erection Function Domain (IIEF-EF) and were divided into 2 groups: 74 men with mild to moderate, moderate, or severe ED (IIEF-EF score ≤18) and without major cardiovascular disease and 26 controls (IIEF-EF score ≥25). Clinical and laboratory evaluations were performed, followed by measurement of the carotid intima-media thickness (IMT) and brachial flow-mediated dilation (FMD) before 4 attempts with 20 mg of vardenafil. The responders had ≥50% positive answers on sexual encounter profile question 3.
  
  
  RESULTS
  The carotid IMT was significantly greater and the FMD was significantly lower in patients with ED than in the control patients. The baseline IIEF-EF score correlated negatively with the carotid IMT (r = -0.48, P < .001) and with the Framingham score (r = -0.41, P < .001) among those with ED. After multivariate logistic regression analysis, the baseline IIEF score was independently and only associated with the carotid IMT (β = 6.105, P = .019). Responders were younger, had a lower cardiovascular risk profile and carotid IMT, and greater baseline IIEF-EF score and FMD than did the nonresponders. On logistic regression analysis, the response to vardenafil was independently associated with the brachial FMD (β = 1.085, P = .002).
  
  
  CONCLUSIONS
  In hypertensive men with vasculogenic ED and no other clinical evidence of arteriosclerosis, the ED severity correlated with the carotid IMT, and phosphodiesterase-5 effectiveness correlated with brachial FMD.
authors: State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. drjavaroni2000@yahoo.com.br
authors: Valter
authors: V
authors: Javaroni
authors: Marcio
authors: M
authors: Queiroz-Miguez
authors: Marcela
authors: M
authors: Abreu-Casanova
authors: Wille
authors: W
authors: Oigman
authors: Mario F
authors: MF
authors: Neves
mesh_terms: D001916:Brachial Artery / Q000503:physiopathology*; D004108:Dilatation, Pathologic; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007093:Imidazoles / Q000627:therapeutic use*; D018783:Impotence, Vasculogenic / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011446:Prospective Studies; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D013450:Sulfones / Q000627:therapeutic use; D014227:Triazines / Q000627:therapeutic use; D000069058:Vardenafil Dihydrochloride
chemical_list: D007093:Imidazoles; D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride