Cardiology Department, Hippocration Hospital, Athens, Greece.
J Clin Hypertens (Greenwich). 2013 Sep;15(9):644-9. doi: 10.1111/jch.12159. Epub 2013 Jul 11.
The authors investigated whether erectile dysfunction (ED) in the early stages of hypertension is associated with heightened end-organ damage. A total of 174 consecutive men with untreated, newly diagnosed essential hypertension (aged 50.3 years, office blood pressure [BP] 150/98 mm Hg) were studied. All participants underwent 24-hour ambulatory BP monitoring, blood examination, albumin-creatinine ratio, carotid-femoral pulse-wave velocity assessment, and echocardiography for estimation of left ventricular mass index and diastolic function. Hypertensive men with ED (n=43, 24.7%) compared with those without ED were older (by 6.4 years, P<.05), had greater 24-hour pulse pressure (by 4.3 mm Hg, P=.011) and a greater prevalence of nondipping status (72.2% vs 46.7%, P=.008), while the two groups did not differ in plasma glucose, lipid, creatinine, and albumin/creatinine ratio levels. Regarding cardiac adaptations, hypertensive men with ED exhibited only significantly lower tissue Doppler imaging-derived Em (by 1.6 cm/s, adjusted P=.035), while no difference in left ventricular mass index or pulse wave velocity were detected. ED in the setting of untreated newly diagnosed essential hypertension does not have an unfavorable impact on traditional markers of target organ damage. This finding suggests that ED assessment might not refine the traditional risk stratification procedure at least in the early stages of hypertensive disease.
作者研究了高血压早期的勃起功能障碍(ED)是否与靶器官损害加重有关。共研究了 174 名连续未经治疗的新诊断原发性高血压男性患者(年龄 50.3 岁,诊室血压 150/98mmHg)。所有参与者均接受了 24 小时动态血压监测、血液检查、白蛋白-肌酐比值、颈动脉-股动脉脉搏波速度评估以及超声心动图检查,以评估左心室质量指数和舒张功能。与无 ED 的高血压男性(n=43,24.7%)相比,ED 患者年龄更大(大 6.4 岁,P<.05),24 小时脉压更大(大 4.3mmHg,P=.011),非杓型血压比例更高(72.2% vs 46.7%,P=.008),而两组在血糖、血脂、肌酐和白蛋白/肌酐比值水平上无差异。在心脏适应性方面,ED 高血压男性仅表现为组织多普勒成像衍生的 Em 明显降低(低 1.6cm/s,校正后 P=.035),而左心室质量指数或脉搏波速度无差异。未经治疗的新诊断原发性高血压患者的 ED 对传统靶器官损害标志物没有不利影响。这一发现表明,ED 评估可能不会至少在高血压疾病的早期阶段细化传统的风险分层程序。