BLOOD PRESSURE AND HEART RATE VARIABILITY IN ERECTILE DYSFUNCTION

Abstract

Objective: Cardiac autonomic dysfunction is associated with increased cardiovascular mortality. No data on sympathovagal balance is available in patients with erectile dysfunction (ED), in whom cardiovascular risk is high. The aim of the study was to assess blood pressure variability (BPV) and heart rate variability (HRV) in patients with hypertension and erectile dysfunction. Design and method: We studied 215 untreated hypertensives (104 diagnosed with ED, mean age 53.9 ± 10.3 and 111 controls, mean age 48.3 ± 11.8). Cardiac autonomic function was evaluated by analysis of short-term BPV and HRV measures over 24-h, daytime, and nighttime using 24-h ambulatory blood pressure monitoring and the standard deviation of the measurements. Echocardiography was also performed and left ventricular mass index (LVMI) was estimated with the Demereux formula. ANCOVA was applied and the comparison between the two groups was adjusted for age, office pulse pressure, body-mass index, history of diabetes, smoking status, LDL and high sensitivity C-reactive protein. Results: In comparison with controls, patients with ED had higher daytime diastolic blood pressure variability (11.2mmHg vs. 10.7mmHg, p = 0.046) and daytime HRV (10.5 beats per minute vs. 10.3 beats per minute, p = 0.033). All other daytime, nighttime and 24 h measurements of BPV and HRV were not different between groups (p > 0.05). At echocardiography, hypertensives with ED had similar LVMI compared to hypertensives without ED (p < 0.05). Conclusions: Compared to controls, ED patients showed a daytime sympathovagal imbalance, characterized by a relatively increased sympathetic activity. Whether this autonomic alteration has a prognostic role in hypertensive ED patients for future cardiovascular events warrants further investigation in prospective studies.