Dynamics of testosterone and prolactin levels, blood pressure and parameters of cardiovascular remodeling in hypertensive men with androgen deficiency in the course of treatment

Abstract

Numerous previous and up-to-date guidelines for antihypertensive treatment do not highlight the problem of interrelations between sexual dysfunction and hypertension itself or with the use of frequently prescribed medications. Changes in testosterone and prolactin concentrations in men undergoing antihypertensive treatment are still not well described.The aim of the study was to investigate the impact of combined antihypertensive treatment with the addition of phenibut on testosterone and prolactin concentrations, blood pressure and parameters of cardiovascular remodeling in hypertensive men with androgen deficiency.Materials and methods. A total of 113 men with stage II essential hypertension were recruited to participate in the study. All patients were subjected to routine clinical examination, evaluation of total (TT), free testosterone (FT) and prolactin using ELISA, 24-hour blood pressure monitoring (24-hour BPM), assessment of central aortic pressure and arterial stiffness, transthoracic echocardiography. All study subjects were prescribed the combined antihypertensive treatment with irbesartan and nifedipine. Depending on treatment scheme, all patients were divided into four groups: group 1A consisted of men with low TT who received phenibut in addition to antihypertensive treatment, group 1B – patients with androgen deficiency on antihypertensive treatment only, group 2A – patients with normal TT with the addition of phenibut, group 2B – men with normal TT on antihypertensive medications only.Results. As a result of prescribed treatment, TT and FT levels increased with discordant changes in the concentration of prolactin: a statistically significant increase in TT (29.72 %, P = 0.0002) and FT (28.08 %, P = 0.0003) with a significant decrease in prolactin concentrations (10.68 %, P = 0.008) were in the group 1A. All patients had positive 24-hour BPM dynamics, parameters of central aortic pressure and cardiovascular remodeling. Patients with androgen deficiency with the addition of phenibut had the highest reduction rates in 24-hour BPM values, central SBP, DBP, PBP, mean BP, augmentation index, RWTT, pulse pressure amplification, CAVIa and were characterized by significant improvement of longitudinal LV deformation and diastolic function.Conclusions. The use of combined antihypertensive therapy with irbesartan and nifedipine with the addition of phenibut in men with androgen deficiency contributes to the achievement of target blood pressure levels and improvement of cardiovascular remodeling parameters.