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勃起功能障碍与血脂异常:5型磷酸二酯酶抑制剂和他汀类药物的相关性及作用

Erectile dysfunction and dyslipidemia: relevance and role of phosphodiesterase type-5 inhibitors and statins.

作者信息

Miner Martin, Billups Kevin L

机构信息

Men's Health Center, The Miriam Hospital, Warren Alpert School of Medicine, Brown University, Swansea, MA, USA;.

Department of Urology, University of Minnesota School of Medicine, VA Medical Center, Minneapolis, MN, USA.

出版信息

J Sex Med. 2008 May;5(5):1066-1078. doi: 10.1111/j.1743-6109.2008.00783.x. Epub 2008 Mar 5.

Abstract

INTRODUCTION

There is a close link between hyperlipidemia/dyslipidemia and erectile dysfunction (ED), with endothelial dysfunction as a common mechanism. Both ED and hyperlipidemia/dyslipidemia are rising in prevalence with mounting evidence that these conditions are harbingers of cardiovascular disease.

AIM

This review was conducted to provide an update on the epidemiology and oral therapy of both dyslipidemia and ED, the connection between these two conditions, and clinical outcomes relating to the use of statins and phosphodiesterase type-5 (PDE5) inhibitors in men with ED who have associated dyslipidemia.

METHODS

A systematic search was performed of MEDLINE and EMBASE research databases to obtain articles pertaining to the epidemiology, mechanism, and clinical outcomes of statins and PDE5 inhibitors in men with ED and associated dyslipidemia.

MAIN OUTCOME MEASURES

The clinical and preclinical studies related to ED and dyslipidemia are analyzed and their findings are assessed and summarized. Results. Hyperlipidemia/Dyslipidemia constitute a vascular risk factor having a considerable impact on erectile function. Furthermore, the role of endothelial dysfunction in the pathophysiology of both ED and dyslipidemia is paramount suggesting the importance of comanaging these conditions. Therefore, hyperlipidemia/dyslipidemia when present in patients with ED should prompt management with diet/exercise as well as appropriate pharmacotherapy. With ED being often associated with comorbidities, the use of concomitant pharmacotherapies enhances opportunities for managing the overall global cardiometabolic risk. Newer studies assessing the effect of PDE5 inhibitors in men with dyslipidemia will shed more light on the clinical profile of these agents when used in this patient population.

CONCLUSIONS

While dyslipidemia and ED are important concerns for clinicians, there exists a gap that needs to be closed between the number of individuals who have either or both conditions and those who are receiving appropriate therapy based on evidence and patient-driven goals regarding clinical outcomes.

摘要

引言

高脂血症/血脂异常与勃起功能障碍(ED)之间存在密切联系,内皮功能障碍是其共同机制。ED和高脂血症/血脂异常的患病率均在上升,且越来越多的证据表明这些病症是心血管疾病的先兆。

目的

本综述旨在提供有关血脂异常和ED的流行病学及口服治疗、这两种病症之间的联系,以及在患有血脂异常的ED男性中使用他汀类药物和5型磷酸二酯酶(PDE5)抑制剂的临床结果的最新信息。

方法

对MEDLINE和EMBASE研究数据库进行系统检索,以获取有关他汀类药物和PDE5抑制剂在患有ED和相关血脂异常男性中的流行病学、机制及临床结果的文章。

主要观察指标

分析与ED和血脂异常相关的临床和临床前研究,并对其结果进行评估和总结。结果。高脂血症/血脂异常是一种对勃起功能有相当大影响的血管危险因素。此外,内皮功能障碍在ED和血脂异常的病理生理学中起着至关重要的作用,这表明共同管理这些病症的重要性。因此,ED患者出现高脂血症/血脂异常时,应通过饮食/运动以及适当的药物治疗进行处理。由于ED常与合并症相关,联合使用药物疗法可增加管理整体心血管代谢风险的机会。评估PDE5抑制剂对血脂异常男性影响的最新研究将为这些药物在该患者群体中的临床特征提供更多信息。

结论

虽然血脂异常和ED是临床医生关注的重要问题,但在患有其中一种或两种病症的个体数量与基于证据和患者驱动的临床结果目标接受适当治疗的个体数量之间仍存在差距,需要加以弥合。

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