Carotid atherosclerosis, aortic stiffness and penile vascular damage in patients with erectile dysfunction: Relation to low density lipoprotein levels and statin therapy

Abstract

Purpose/Background/ObjectivesAim of the study is to examine the possible differentiation of aortic stiffness, carotid atherosclerosis and penile vascular function among patients with erectile dysfunction (ED) according to cholesterol level and statin therapy.MethodsWe measured carotid intima-media thickness (IMT), carotid-femoral pulse wave velocity (PWV) and penile peak systolic velocity (PSV) 20 min after intracavernous injection of prostaglandin E1 in 356 consecutive ED patients (mean age 57 ± 9 years). Lipid parameters and total testosterone were measured in all patients.Results95 (26.7%) ED patients are treated with statins. The patients not receiving statin therapy (n = 261) were subsequently divided into three groups according to LDL level (group 1: LDL <100 mg/dl, group 2: LDL: 100–155 mg/dl, group 3: LDL > 155 mg/dl).Patients with statin therapy and subjects in group 2 have similar mean LDL level. Carotid IMT was higher in patients with LDL >155 mg/dl (group 3) compared to patients treated with statins (P = 0.01) and subjects with LDL: 100–155 mg/dl (P = 0.005) and LDL < 100 mg/dl (left plot, P < 0.001). Post hoc analysis showed that patients treated with a statin and subjects in group 3 had comparable penile PSV and lower mean value compared to that of patients in group 1 and group 2 (right plot).Carotid-femoral PWV was similar between the studied groups. Testosterone levels were similar between patients treated with a statin and males not receiving hypolipidemic therapy (groups 2 and 3).ConclusionsAlthough treated hypercholesterolemic patients exhibited lower atherosclerotic burden compared to untreated individuals with high LDL levels, penile blood inflow remains significantly impaired.