Male Hypertensive Patients Research Articles

Life threatening perioperative arrhythmias and hypokalemia

Background: Perioperative arrhythmia is a common general anesthesia complication of cardiothoracic surgeries. Sudden or acute onset of life threatening perioperative arrhythmias are rare clinical events in non-cardiac surgical patients.1,2 Electrolytes imbalance, particularly hypokalemia and dyskalemia, is one of the main possible underlining cause for the occurrence of these arrhythmias.3,4,5 We present two cases of severe hypokalemia leading to life threatening cardiac arrhythmias in the post-operative period. Case 1: A 30-year old healthy female patient without significant past medical history had emergency laparoscopic cholecystectomy and appendicectomy. Pre- and intra-operative periods were uneventful. Her pre-operative potassium level was 3.7 mmol/L. 18 hours post-operatively, she suddenly developed palpitations and went into ventricular fibrillation (VF) cardiac arrest. Cardiopulmonary resuscitation (CPR) was initiated followed by defibrillation which reverted the heart to a sinus rhythm. She was transferred to the intensive care unit (ICU) sedated and connected to the ventilator. In ICU, her serum electrolytes showed severe hypokalemia (serum potassium level 2.2 mmol/L) (Figure 1) so she was immediately started on 20 mmol of potassium chloride (KCl) over 30 minutes through central venous catheter (CVC) with complementary intravenous fluids with KCl. In the next 36 minutes she had four episodes of VF requiring CPR and defibrillation with a positive outcome. She received amiodarone infusion as well as continuous KCl supplementation and calcium gluconate 2 g. She received 100 mmol of KCl in 6 hours and a total of 220 mmol of KCl in 24 hours, and then she became stable. She was extubated after 48 hours. Echocardiogram and cardiac conduction studies showed no pathological changes. Cardiac conduction studies (electrophysiology study - EPS) were normal. She was discharged home and followed in the outpatient clinic. Case 2: A 78-year old known hypertensive male patient on angiotensin converting enzyme inhibitors was admitted to intensive care unit (ICU) for observation after laparoscopic cholecystectomy. Pre-operative serum electrolytes were within normal range. After one hour he started to have tachycardia and then went into pulseless ventricular tachycardia requiring defibrillation. His serum electrolytes results showed severe hypokalemia (2.4 mmol/L) (Figure 1) so this was corrected by rapid potassium chloride administration through CVC and supplementation of KCl in intravenous fluids. After 10 minutes he went into VF requiring defibrillation and a bolus of amiodarone. In the next 20 minutes he had three more episodes of VF requiring CPR and defibrillation.In six hours he required 90 mmol of KCl to reach a serum potassium level of 3.7 mmol/L. A total of 210 mmol of KCl was needed in 24 hours. He was extubated after 24 hours. He was transferred to the ward on day 3 and discharged home on day 6, and later followed in the outpatient clinic. Conclusion: Perioperative severe hypokalemia can lead to life threatening cardiac arrhythmias. Early recognition and aggressive correction through perioperative potassium supplementation is essential for better outcome. Daily potassium level assessment and supplementation should be done in the perioperative period.

A Cross-sectional study to explore Sexual dysfunctions among male Hypertensive Patients attending Medicine OPD of Tertiary care centre, Western India

A Cross-sectional study to explore Sexual dysfunctions among male Hypertensive Patients attending Medicine OPD of Tertiary care centre, Western India

Silent Ischemic Stroke Was Revealed after Screening for Cognitive Dysfunction in a Hypertensive Patient with New Onset Atrial Fibrillation – Case Report

Abstract Introduction: Hypertension is one of the most important modifiable risk factor related to cognitive decline and dementia. However, screening for cognitive dysfunction is not part of the routine clinical assessment. Case presentation: In this report, we present the case of a 75 year old hypertensive male patient with new-onset atrial fibrillation, admitted to the Cardiovascular Rehabilitation Clinic Târgu Mureș. Apart from the routine clinical assessment, the evaluation of cognitive functions was performed with three different screening instruments which identified cognitive dysfunction. Depressive state was assessed with the shortened 13 items form of the Beck Depression Inventory BDI-13 (BDI-13) and it showed moderate depression which could influence the results of cognitive tests. Detection of cognitive impairment was followed by magnetic resonance imaging, which revealed not only hypertension specific microvascular impairment but also a sequelae of a former stroke in the territory of the left middle cerebral artery and a possible meningioma. Conclusion: Screening for cognitive dysfunction in high-risk hypertensive patients can be easily performed and in several cases like ours, can unmask silent cerebrovascular pathologies, leading to prognostic and therapeutic consequences.

Correlation of pupil to limbus diameter ratio (PLD ratio) with blood pres-sure and pulse rate in hypertensive males

Hypertension is known to be a major risk factor for coronary artery disease, stroke, heart failure, vision loss which remains asymptomatic until late in its course and even severely elevated pressures can be clinically silent for years. Measurement of diameter of the pupil is indicative of autonomic function, and recording of the pupil to limbus diameter (PLD) ratio correlates with alterations in blood pressure. As hypertension is more prevalent in males and the incidence is increasing year by year, measurement of PLD ratio can be used as a simple screening tool in the general population to measure the autonomic alterations associated with changes in blood pressure. This study aims at finding the correlation of pupil to limbus diameter (PLD) ratio with blood pressure and pulse rate in Hypertensive Males. 45 male patients attending O/P of Saveetha Medical College and Hospital in the age group of 30 to 65 years, fulfilling the inclusion criteria were enrolled in the study. It's a case-control study with non-probability convenient sampling. Blood pressure, using a sphygmomanometer and pulse rate were measured by the physician according to AHA criteria, and PLD ratio was assessed by the two-box method. There was a significant decrease observed in PLD ratio when normal and hypertensive groups. Mean pulse rate of hypertensive males was significantly higher compared to the control group. The systolic blood pressure and diastolic blood pressure were significantly high in hypertensive male patients. A significant difference in PLD ratio exists between the control and hypertensive males though no positive correlation was observed.

Effect of an adapted physical activity program on the morphological and physiological profile of hypertensive patients of University Clinics of Kinshasa

Objectives: The treatment of arterial hypertension requires a comprehensive care because it is necessary not only to take the prescribed medication but also to apply certain rules of hygiene. The purpose of this study was to evaluate the effect of a program of physical activity adapted to the morphological and physiological state of the hypertensive patients. Methods: An experimental study was conducted on a sample of 31 male hypertensive patients with an average age of 58.16 ± 3.7 years undergoing an aerobic and anaerobic physical activity program treadmill walking, cycling, ergonomics and aerobic exercise and muscle building exercises of moderate intensity, duration of forty-five minutes and a frequency of three times a week associated with low calorie nutrition education low in cholesterol and saturated fatty acids (bad fats) , low sodium rich in vegetables, fruits and vitamins for 4 months at the University Clinics of Kinshasa between January 2017and May 2017. Results: After 4 months of intervention, we found statistically significant reductions in weight -7.2 kg, waist circumference -7.61 cm, body mass index -5.42 kg/m2, visceral fat percentage -1.4%, systolic blood pressure -6 mmHg, low-density lipoprotein -22 mg/dL, triglyceride -26.7 mg/dL with the exception of high-density lipoprotein and muscle that statistically increased +7.42 mg/dL and +15.3% while diastolic blood pressure -3.4 mmHg was not statistically modified. Conclusion: The practice of adapted physical activities combined with nutritional education improves the morphological and physiological status of hypertensive patients.

Is social support associated with hypertension control among Ghanaian migrants in Europe and non-migrants in Ghana? The RODAM study

Hypertension (HTN) control is crucial in preventing HTN-related complications such as stroke and coronary heart disease. Yet, HTN control remains suboptimal particularly among sub-Saharan African (SSA) populations partly due to poor self-management. Self-management of HTN is influenced by social support, but the evidence on the role of social support on HTN control particularly among SSA populations is limited. This study assessed the association between multiple proxies for social support and HTN control among Ghanaians resident in Ghana and Europe. The Research on Obesity and Diabetes among African Migrants (RODAM) study participants with HTN and who self-reported HTN (n = 1327) were included in this analysis. Logistic regression was used to assess the association between proxies of social support and HTN control (SBP < 140 mmHg and DBP < 90 mmHg) with adjustments for age and socioeconomic status (SES). Among Ghanaian males in both Europe and Ghana, cohabiting with more than two persons was associated with increased odds of having HTN controlled. Male hypertensive patients cohabiting with ≥ 5 persons had the highest odds of having HTN controlled after adjustment for age and SES (OR 0.30; 95% CI 0.16–0.57; 0.60; 0.34–1.04, respectively). This association was not observed among females. Relationship status, frequency of religious activity attendance and satisfaction with social support did not show any significant association with HTN control. Our study shows that cohabitation is significantly associated with HTN control but in males only. The other proxies for social support appeared not to be associated with HTN control. Involving persons living with Ghanaian men with HTN in the treatment process may help to improve adherence to HTN treatment. Further research is needed to explore in-depth, how these social support proxies could contribute to improved HTN control among SSA populations.

Primary Hyperaldosteronism Presenting as Hypokalemic Paralysis

International Journal of Medicine and Public Health,2019,9,1,31-33.DOI:10.5530/ijmedph.2019.1.8Published:March 2019Type:Case ReportPrimary Hyperaldosteronism Presenting as Hypokalemic ParalysisOza Harsh Nikhilkumar, and Dave Ruchir Bakulesh Oza Harsh Nikhilkumar*, Dave Ruchir Bakulesh Department of medicine, Sheth v.s. General Hospital, Ahmedabad, Gujarat, INDIA. Abstract:Primary Hyperaldosteronism is excess production of aldosterone by the adrenal glands resulting in low renin levels. It is frequently associated with metabolic alkalosis and hypokalemia which may lead to intermittent attacks of paralysis. A young hypertensive male patient, on regular treatment with tablet losartan 50 mg and tablet amlodipine 5 mg, once a day since last 4 years, presented with acute onset weakness of all four limbs. Serum potassium levels were found to be 1.6 mmol/L, (normal range 3.5-5.1 mmol/L). He was treated with potassium supplements and after 3 days, his potassium levels were 3.6 mmol/L, with improvement in his weakness. Tablet losartan was stopped and aldosterone to renin ratio with simultaneous potassium levels were ordered. The ratio was high (42.53) [reference range: 0.9-28.9] with simultaneous potassium levels of 3.5 mmol/L. CECT abdomen also confirmed the presence of adrenal adenoma. One must be vigilant in evaluating for underlying causes in a patient presenting with hypokalemic hypertension. We report a case of conn’s syndrome presenting with hypokalemic paralysis. Keywords:Adrenal adenoma, Hypokalemia, Paralysis, Primary hyperaldosteronism, Young hypertensiveView:PDF (344.2 KB)

Dietary Supplementation of Quercetin and the Reproductive Functions in Hypertensive Male Rats

AbstractBackground: Hypertension is considered one of the com-monest medical problems and affects more than 25% of the general population, with its prevalence increases with age. It is associated with a wide variety of health challenges like stroke, heart failure, renal failure and reproductive disorders.Aim of Study: The prevention of hypertension induced reproductive impairment remains unclear. Hence, the aim of the present study was to investigate the possible protective effects of quercetin on male reproductive functions in L-NAME- induced hypertensive rats.Material and Methods: 50 Male Wister Albino rats (200- 220g) were divided into 5 groups 10 per each. G1: The control group was placed on the basal diet (received saline with the same volume used to dissolve L-NAME and quercetin by gavage) for 4 weeks. G 2: The Quercetin group was adminis-tered with Quercetin 50mg/Kg b.w. by gavage for 4 weeks. G 3: The L-NAME group (hypertensive induced group received L-NAME (40mg/Kg/day by gavage) for 4 weeks. G 4: The L-NAME plus atenolol received L-NAME plus atenolol (10 mg/kg/day) by gavage for 4 weeks. G 5: The L-NAME plus Quercetin received L-NAME (40mg/Kg/day) plus quercetin 50mg/Kg b.w. by gavage for 4 weeks.Results: Quercetin abrogated the mean blood pressure elevation induced by L-NAME. Administration of quercetin increased the antioxidant enzyme activities and glutathione, whereas it suppressed the oxidative stress biomarkers and the arginase activity. Quercetin significantly restored hypertension induced impairment of luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone hormone. Quer-cetin improves the sperm motility and viability. Histopatho-logical findings supported our results.In Conclusion: Quercetin supplementation may be con-sidered a beneficial approach targeting reproductive deficits in male hypertensive patients.

Correlation of renal volume on ultrasound with renal function tests in hypertensives in University of Benin Teaching Hospital

Background: Long-standing essential hypertension can initiate changes in renal size and alteration in renal function which can be assessed using ultrasound and biochemical tests, respectively. Ultrasound is a noninvasive and affordable investigative modality that is readily available. Patients and Methods: One hundred and fifty patients consisting of 54 (36%) males and 96 (64%) females with essential hypertension attending cardiology outpatient clinic were recruited and investigated after obtaining an informed consent. Renal volume was calculated from ultrasound measurement of renal dimensions. Blood sample was assessed for serum creatinine and estimated glomerular filtration rate calculated using the Cockcroft and Gault (CG) and modification of diet in renal disease (MDRD) formulae. Data analysis was performed using Statistical package for Social Sciences version 17.0. Results: The mean renal volume was 115.7 ± 29.2 cm3 on the right and 132.4 ± 40.2 cm3 on the left. The mean renal volumes for males were 126.1 ± 27.9 cm3 and 141.1 ± 40.6 cm3 while values for female patients were 109.9 ± 28.2 cm3 and 127.5 ± 9.4 cm3 on the right and left, respectively. Differences in renal sizes on both sides were not statistically significant, P = 0.120 and 0.063. Values were significantly higher in male patients compared to the female patients, for both sides (P = 0.001 and 0.046 on the right and left, respectively). Mean serum creatinine was 0.9 ± 0.03 mg/dl. Conclusion: Male hypertensive patients had significant higher renal volume values than females. However, renal volume did not correlate with duration of hypertension for all the patients. There was no correlation between renal volume and renal function using CG and MDRD formula.

Особенности структурно-функциональных параметров глубоких вен нижних конечностей у мужчин с артериальной гипертензией

Особенности структурно-функциональных параметров глубоких вен нижних конечностей у мужчин с артериальной гипертензией

Relationship between hyperuricemia and erectile dysfunction on hypertension patients

Hypertension is a major non-communicable disease worldwide including in Indonesia. It can cuase erectile dysfunction through vasculogenic pathway. Uric acid level could be a promising biomarker to predict erectile dysfunction due to it is related to endothelial dysfunction, microvascular disease, and hypertension. The aim of this study was to evaluate the relationship between hyperuricemia and erectile dysfunction on hypertension patients. This was an observational study with cross-sectional design involving 88 male hypertension patients aged more than 18 years who registered as outpatient in the Bethesda Lempuyangwangi Public Hospital, Yogyakarta. Hyperuricemia was measured using uricase method and erectile dysfunction was measured using IIEF-5 form. The results showed that hyperuricemia (OR=3.89; CI 95% 1.08-15.70; p=0.017), blood pressure (OR=6.84; CI 95% 2.35-20.6; p<0.001), and age (p<0.001) are related with erectile dysfunction on the hypertension patients. Furthermore, logistic regression analysis showed that hyperuricemia, age, and blood pressure simultaneously affect the erectile dysfunction occurance, with good calibration (p=0.167) and discriminative level (0.8604). In conclusion, there is significantly relationship between hyperuricemia and erectile dysfunction on hypertension patients.

Effect of duration of hypertension on heart rate variability

Background: Hypertension is the most prevalent noncommunicable disease. It is a multisystem disorder that affects many organs of the body including cardiovascular system, and it markedly increases both morbidity and mortality in the population. Hypertension causes dysfunction of the cardiac autonomic nervous system leading to sympathovagal imbalance. Heart rate variability (HRV) is a non-invasive tool used to detect variation in RR intervals and has been proposed as early markers of vulnerability to ventricular arrhythmias. The present study was taken up to measure the effect of duration of the hypertension on HRV for early detection and early management of cardiac abnormalities. Aims and Objectives: The objectives of the study were to evaluate the effect of duration of the hypertension on cardiac autonomic function in patients with primary hypertension by measuring HRV. Materials and Methods: HRV test was performed on 50 male hypertensive patients who were divided into 2 groups, based on the duration of hypertension, i.e., duration of hypertension >5 years and 5 years duration (P 5 years, and it was highly significant. P < 0.001 showing decreased in parasympathetic activity in long-standing hypertension. Conclusion: Study showed reduced HRV parameters showing decreased parasympathetic activity in long-standing hypertension leading to an imbalance in cardiac autonomic function. It is very much important to evaluate the cardiac autonomic function status in long-standing hypertension using simple non-invasive tools for early detection and treatment of cardiac arrhythmias and other variations in cardiac function status.

Cost-Utility of an Objective Biochemical Measure to Improve Adherence to Antihypertensive Treatment.

Nonadherence to antihypertensive medications is known to be a major health problem. Novel biochemical analyses using liquid chromatography-tandem mass spectrometry are becoming accepted as a clinically useful objective measure to manage (non)adherence in Hypertension Clinics. Discussion of results from such analyses with patients can significantly improve adherence and blood pressure control. Our objective was to model the cost-effectiveness of performing liquid chromatography-tandem mass spectrometry-based analyses in improving adherence in patients with hypertension. Lifetime cost-utility was assessed from a UK healthcare payer perspective, using a Markov model. Efficacy was based on study findings of lowering blood pressure because of improved adherence to drug treatment. Cost and utilities were derived from literature. The base case cohort consisted of males aged 65 years. Subgroup analyses included varying population sex and age and a subgroup of patients with apparent resistant hypertension. Additionally, univariate and probabilistic sensitivity analyses were performed. Our findings are reported after the Consolidated Health Economic Evaluation Reporting Standards checklist. Per patient, screening resulted in 0.020 incremental quality-adjusted life-years and a negative incremental cost of £495, suggesting the intervention to be dominant compared with care as usual. Targeting younger patients or patients with apparent resistant hypertension would further improve these outcomes. Modeling suggested that screening prevented 518 myocardial infarctions and 305 stroke events in a cohort of 10 000 male hypertensive patients. Using liquid chromatography-tandem mass spectrometry-based biochemical analyses to improve adherence in hypertensive patients is likely to be an effective and cost-saving strategy, especially in patients with apparent resistant hypertension.

A16299 Interaction between Neutrophil to Lymphocyte Ratio and Arterial Stiffness in Hypertensive Patients

Objectives: Increased arterial stiffness in patients with hypertension is associated with adverse cardiovascular outcomes. Inflammation plays a role in the development of arterial stiffness. Neutrophil to lymphocyte ratio (NLR) may exhibit inflammation. We thus investigated the association of arterial stiffness with NLR and hs-CRP in hypertensive patients. Methods: We retrospectively analyzed the results of a cohort of individuals from Kailuan Company in Hebei province undergoing health examinations. A total of 6,023 hypertensive patients were recruited. We analyzed the association between NLR, hs-CRP and brachial-ankle pulse wave velocity (baPWV) using linear regression. Results: We found that the level of NLR, hs-CRP and baPWV were significantly increased among hypertensive patients. Adjusted NLR, PLR and hs-CRP are gradually increased across the quartiles of NLR. A significantly increased baPWV was found in the highest quartile of NLR (P < 0.001). The multivariate linear regression analysis demonstrated NLR and hs-CRP were significant related with increased baPWV in hypertension. In male hypertensive patients, NLR and hs-CRP were statistically significant related with baPWV (P < 0.01, respectively). In older hypertensive patients, NLR had showed a significant association with baPWV (P < 0.01). NLR and hs-CRP were showed strong association with baPWV in untreated hypertensive patients (P < 0.01). Conclusion: Increased NLR and hs-CRP are associated with an increased baPWV in hypertensive patients. As an easy and inexpensive laboratory measure, NLR may provide important information regarding arterial stiffness in hypertension.

A0939 The relationship between angiotensin converting enzyme gene polymorphism and hypertension

Objectives: The human angiotensin converting enzyme (ACE) gene is often found in the stool Chromosome 17q23, according to a 287 bp sequence located in its intron 16 column exists or not, divided into insert (¢ñ) and deletion (D) alleles Gene. There are three genotypes included II, ID, DD. The ACE gene polymorphisms have been suggested to be linked to increase risk of hypertension. However, the results are still controversial. Therefore, the purpose of this meta-analysis is to further confirm the relationship between ACE gene and hypertension with different genders. Methods: We searched PubMed, Cochrane Library, Embase, Web of Science and so on from their commencement to Oct. 2017 with free text word and MeSH by using these search terms as follows: “hypertension”, “blood pressure”, “ angiotensin converting enzyme “, “polymorphism”. Thirty studies involved 8317 patients were enrolled. Results: We got the conclusions. Compared with the Chinese normotensive patients, hypertensive patients were with higher expression of DD gene[odds ratio (OR) = 1.56; 95% Confidence interval (CI): 1.23, 1.98, P = 0.0002], normotensive patients with higher expression of II gene (OR = 0.79; 95%CI: 0.70, 0.90, P = 0.0002).Considering for the differences of gender in foreigners, there is no significant difference among the three genotypes. In Chinese population, the DD gene in female hypetensive patients was higher expression than normotensive patients (P = 0.04). However, the II gene in male hypertensive patients was higher expression than normotensive patients (P = 0.003). Conclusion: In the general population, the DD gene in the ACE gene polymorphism is more susceptible to hypertension. Additionally, this trend also exists in the chinese female hypertensive patients, but the trend disappeared in chinese males hypertensive patients.

A13091 Impact of ACE2 gene polymorphism on antihypertensive efficacy of ACE inhibitors

Objectives: Angiotensin-converting enzyme 2 (ACE2), a newly discovered member of renin-angiotensin-aldosterone system, counterbalances the actions of angiotensin-converting enzyme. Methods: The objective of our study was to assess the association between rs2106809 polymorphism in ACE2 gene and the blood pressure response to ACE inhibitors in untreated hypertensive patients. After a 2-week, double-blind placebo run-in period, either benazepril or imidapril was administered for 6 weeks to 497 patients with mild to moderate essential hypertension. Results: The achieved changes in BP were analyzed for their association with genotypes at ACE2 gene loci. In female hypertensive patients, the genotype frequency of ACE2 rs2106809 was 36.7%, 45.2% and 18.1% for CC, CT and TT genotypes, respectively. After 6 weeks of treatment, the reductions in diastolic blood pressure were significantly greater in female patients carrying the CC or CT genotype compared with those carrying the TT genotype (9.62 ± 6.83 or 10.2 ± 7.2 versus 6.81 ± 6.31 mmHg, respectively; P = 0.045, analysis of variance (ANOVA)). Moreover, the reductions in mean arterial pressure were significantly greater in female patients carrying the CC or CT genotype compared with those carrying the TT genotype (12.1 ± 7.5 or 12.0 ± 7.9 versus 8.38 ± 6.83 mmHg, respectively; P = 0.035, ANOVA). In male hypertensive patients, the genotype frequency of ACE2 rs2106809 was 58.1% and 41.9% for C and T genotypes, respectively. However, no association could be observed in males. Conclusion: We conclude that ACE2 rs2106809 is an important predictive factor of the response to antihypertensive treatment with ACE inhibitors in Chinese female hypertensive patients.

A0944 The relationship between angiotensin converting enzyme gene polymorphism and hypertension

Objectives: The human angiotensin converting enzyme (ACE) gene is often found in the stool Chromosome 17q23, according to a 287 bp sequence located in its intron 16 column exists or not, divided into insert (¢ñ) and deletion (D) alleles Gene. There are three genotypes included II, ID, DD. The ACE gene polymorphisms have been suggested to be linked to increase risk of hypertension. However, the results are still controversial. Therefore, the purpose of this meta-analysis is to further confirm the relationship between ACE gene and hypertension with different genders. Methods: We searched PubMed, Cochrane Library, Embase, Web of Science and so on from their commencement to Oct. 2017 with free text word and MeSH by using these search terms as follows: “hypertension”, “blood pressure”, “ angiotensin converting enzyme “, “polymorphism”. Thirty studies involved 8317 patients were enrolled. Results: We got the conclusions. Compared with the Chinese normotensive patients, hypertensive patients were with higher expression of DD gene[odds ratio (OR) = 1.56; 95% Confidence interval (CI): 1.23, 1.98, P = 0.0002], normotensive patients with higher expression of II gene (OR = 0.79; 95%CI: 0.70, 0.90, P = 0.0002).Considering for the differences of gender in foreigners, there is no significant difference among the three genotypes. In Chinese population, the DD gene in female hypetensive patients was higher expression than normotensive patients (P = 0.04). However, the II gene in male hypertensive patients was higher expression than normotensive patients (P = 0.003). Conclusion: In the general population, the DD gene in the ACE gene polymorphism is more susceptible to hypertension. Additionally, this trend also exists in the chinese female hypertensive patients, but the trend disappeared in chinese males hypertensive patients.

A8539 Help male hypertension patients quit smoking using brief advice and risk factor counseling in community health centre

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THE IMPACT OF DIURETICS ON ERECTILE FUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION

Objective: Erectile dysfunction is frequently encountered in hypertensive patients. Along with blood pressure elevation, antihypertensive drugs have been implicated in the pathogenesis of erectile dysfunction. Although the effects of diuretics on erectile function seem detrimental, contradictory findings are available in the literature. We therefore aimed to evaluate the impact of diuretic therapy on erectile function in hypertensive patients without erectile dysfunction. Design and method: Consecutive male hypertensive patients between 30 and 70 years of age attending our Hypertension Outpatient Clinic who initiated diuretic therapy participated in the study. Erectile function was evaluated at baseline and three months after diuretic initiation. Erectile function was assessed using the International Index of Erectile Function, a validated 15-item questionnaire. Results: Overall, 247 male hypertensive patients participated in the study. Diuretic monotherapy was initiated in 56 participants, while diuretics were added to prior therapy in the rest 191 participants. From the latter group, 122 were on monotherapy with angiotensin receptor blockers and 69 were on dual therapy with angiotensin receptor blockers plus calcium antagonists. Erectile dysfunction appeared in 8/56 participants (14.2%) on diuretic monotherapy, in 27/122 participants (22.1%) on dual therapy with diuretics added to ARBs, and in 14/69 participants (20.3%) on triple therapy (diuretics on top of prior ARBs plus calcium antagonists administration). Conclusions: Diuretic-induced erectile dysfunction is common among patients with arterial hypertension. Further studies are needed to verify our findings, enlighten the mediating mechanisms, and clarify the management of such patients.

FEMALE SEXUAL DYSFUNCTION WITH DIURETICS IN WOMEN WITH ARTERIAL HYPERTENSION

Objective: Sexual dysfunction is more prevalent in female than in male hypertensive patients. Although the pathophysiology of female sexual dysfunction is more complex than the male one, antihypertensive drugs seem to contribute to female sexual dysfunction. The role of diuretics in female sexual dysfunction remains largely unclarified. We therefore aimed to evaluate the impact of diuretic therapy on female sexual function in hypertensive women free of sexual dysfunction. Design and method: Consecutive female hypertensive patients between 30 and 70 years of age attending our Hypertension Outpatient Clinic who initiated diuretic therapy participated in the study. Female sexual function was evaluated at baseline and three months after diuretic initiation. Female sexual function was assessed using the Female Sexual Function Index, a validated 19-item questionnaire. Results: In total, 218 female hypertensive patients participated in the study. Diuretics were introduced either as monotherapy in patients not taking antihypertensive drugs (58 patients) or as part of combination therapy in patients already taking angiotensin receptor blockers (103 patients) or angiotensin receptor blockers plus calcium antagonists (57 patients). Female sexual dysfunction occurred in 6/58 (10.3%) participants on diuretic monotherapy, in 18/103 (17.4%) participants on dual therapy (ARBs and diuretic addition), and in 9/57 (15.8%) participants on triple therapy (prior ARBs+calcium antagonists and diuretic addition). Conclusions: Initiation of diuretic therapy is associated with incident female sexual dysfunction in 10–20% of women with arterial hypertension. Further studies are needed to verify our findings, enlighten the mediating mechanisms, and clarify the management of such patients.