RELATIONSHIP BETWEEN OBSTRUCTIVE SLEEP APNOEA AND ERECTILE DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

Objective: The aim of our study was to determine the impact of obstructive sleep apnea (OSA) on erectile dysfunction (ED) in patients with arterial hypertension (AH). Currently, ED is evaluated as a predictor of cardiovascular diseases. Design and method: We included 71 men (mean age 47,9 ± 9,2 years) with AH, receiving antihypertensive therapy (except b-blockers), OSA and ED (according to the IIEF-5 questionnaire), not suffering from coronary artery disease and diabetes mellitus. All patients underwent sleep study and 21 patients underwent intracavernous pharmacodopplerography (IPD) with alprostadil, which included an assessment of the erection degree (Er scale, from 0 to 5), penile blood flow parameters such as peak systolic velocity (PSV), end diastolic velocity (EDV) and a resistive index (RI). The results of IPD were compared with the IIEF-5 questionnaire.Results: Statistical analysis showed no correlation between the severity of ED according to IIEF-5 and IPD (r = .42, p = .07), as well as no correlation has been shown between the severity of OSA and ED by IIEF-5 (r = .20, p = .10). 21 patients who underwent IPD had mean AHI 25,6 ± 18,1/h; mean ODI – 21,6 ± 20,8/h; mean SBP was 146,4 ± 12,1 mm Hg and mean DBP – 8,6 ± 8,7 mm Hg. We found statistically significant correlation between parameters of OSA and severity of ED, such as apnea/hypopnea index (AHI) and Er 0–5, PSV and RI (r = −.50, p = .02; r = −.52, p = .02; r = −.67, p = .0009 respectivly); oxygen desaturation index (ODI) with PSV and RI (r = −.61, p = .003; r = −.60, p = .003 respectivly). A statistically significant correlation between the quality of penile blood flow and the systolic blood pressure (SBP) was revealed too (r = .49, p = .02). Conclusions: There is a significant correlation between the level of SBP, the severity of OSA and ED according to objective method of its evaluation.