Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

The correlation between high sensitivity C-reactive protein and erectile dysfunction patients with hypertension treated with vardenafil

Abstract

We evaluate the correlation between the plasma level of C-reactive protein (CRP) in patients with erectile dysfunction (ED) and hypertension and to set up whether the CRP level affected by the treatment of vardenafil 10 mg orally once daily. A total of 116 male patients with ED and hypertension were enrolled in this prospective study. The patients were divided into two groups, group 1 (ED patients with Not controlled hypertension) and group 2 (ED patients with controlled hypertension). All patients completed the International Index of Erectile Function (IIEF) scores, performed a penile color Doppler ultrasound examination and high sensitivity (hs-CRP) levels. The patients were given vardenafil 10 mg once daily for 3 months and reassessed again. According to the IIEF-EF domain score, there were statistically significant differences between the two groups (P=0.012) with a median value 10.0 (4.0–14.5) and 15.0 (9.0–16.5) between group 1 and group 2, respectively. Regarding to the severe (score<11), moderate (score 11–16) and mild (score 17–25) there were statistically significant differences between the two groups (0.023), (0.001) and (0.001), respectively. The hs-CRP showed statistically significant difference between the two groups (P=0.050) with a median value 2.4 (1.5–3.1) and 1.8 (1.1–2.4) between group 1 and group 2, respectively. The peak systolic velocity (PSV) and end diastolic velocity (EDV) showed statistically significant differences between the two groups (P=0.011) and (P=0.046), respectively. After treatment, there were improvements in the IIEF-EF domain score, severe (score<11), moderate (score 11–16), mild (score 17–25), PSV and EDV in both groups and these improvement were more obvious in (group 2) than (group 1) with a statistically significant differences between the two groups (P<0.05) (except in moderate (score 11–16), no statistically significant difference). The hs-CRP showed statistically significant differences between the two groups after treatment (P=0.049) with a median 2.1 (1.6–2.9) and 1.2 (0.9–2.4) between group 1 and group 2, respectively. Serum hs-CRP was significantly elevated in patients with ED and not controlled hypertension than in ED patients with controlled hypertension. ED patients with controlled blood pressure gave better results with penile duplex than those with not controlled blood pressure. Serum hs-CRP level could be a marker for an endothelial condition in men with ED and hypertension.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. NIH Consensus Conference. Impotence, NIH consensus development panel on impotence. J Am Med Assoc 1993; 270: 83–90.

    Article  Google Scholar 

  2. Ayta IA, McKinlay JB, Krane RJ . The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 1999; 84: 50–56.

    Article  CAS  Google Scholar 

  3. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    Article  CAS  Google Scholar 

  4. Montorsi P, Montorsi F, Schulman CC . Is erectile dysfunction the ‘tip of the iceberg’ of asystemic vascular disorder? Eur Urol 2003; 44: 352–354.

    Article  Google Scholar 

  5. El-Sakka AI, Morsy AM, Fagih BI, Nassar AH . Coronary artery risk factors in patients with erectile dysfunction. J Urol 2004; 172: 251–254.

    Article  Google Scholar 

  6. Vlachopoulos CV, Terentes-Printzios DG, Ioakeimidis NK, Aznaouridis KA . Prediction of cardiovascular events and all-cause mortality with erectile dysfunction: a systematic review and meta-analysis of cohort studies. Circ Cardiovasc Qual Outcomes 2013; 6: 99–109.

    Article  Google Scholar 

  7. Guo W, Liao C, Zou Y, Li F, Li T, Zhou Q et al. Erectile dysfunction and risk of clinical cardiovascular events: a meta-analysis of seven cohort studies. J Sex Med 2010; 7: 2805–2816.

    Article  Google Scholar 

  8. Corona G, Monami M, Boddi V, Rastrelli G, Melani C, Balzi D et al. Pulse pressure independently predicts major cardiovascular events in younger but not in older subjects with erectile dysfunction. J Sex Med 2011; 8: 247–254.

    Article  Google Scholar 

  9. Brunner H, Cockcroft JR, Deanfield J, Donald A, Ferrannini E, Halcox J et al. Working group on endothelins and endothelial factors of the european society of hypertension endothelial function and dysfunction. Part II: association with cardiovascular risk factors and diseases. A statement by the working group on endothelins and endothelial factors of the european society of hypertension. J Hypertens 2005; 23: 233–246.

    Article  CAS  Google Scholar 

  10. Aversa A, Bruzziches R, Francomano D, Natali M, Gareri P . Endothelial dysfunction and erectile dysfunction in the aging man. Int J Urol 2010; 17: 38–47.

    Article  Google Scholar 

  11. Jensen JA, Lendorf H, Stimple J, Frost, Ibsen H, Rosenkilde P . The prevelance and etiology of Impotence in 101 male hypertensive patients. Am J Hypertens 1999; 12: 271–275.

    Article  CAS  Google Scholar 

  12. Corona G, Fagioli G, Mannucci E, Romeo A . Penile doppler ultrasound in patients with erectile dysfunction (ED): role of peak systolic velocity measured in the flaccid state in predicting arteriogenic ED and silent coronary artery disease. J Sex Med 2008; 5: 2623–2634.

    Article  Google Scholar 

  13. Ridker PM . High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation 2001; 103: 1813–1818.

    Article  CAS  Google Scholar 

  14. Fichtlscherer S, Rosenberger G, Walter DH, Breuer S, Dimmeler S, Zeiher AM et al. Elevated C-reactive protein levels and impaired endothelial vasoreactivity in Patients with coronary artery disease. Circulation 2000; 102: 1000–1006.

    Article  CAS  Google Scholar 

  15. Muller A, Mulhall JP . Cardiovascular disease, metabolic syndrome and erectile dysfunction. Curr Opin Urol 2006; 16: 435–443.

    Article  Google Scholar 

  16. Schwartz BG, Jackson G, Stecher VJ, Campoli-Richards DM, Kloner RA . Phosphodiesterase type 5 inhibitors improve endothelial function and may benefit cardiovascular conditions. Am J Med 2013; 126: 192–199.

    Article  CAS  Google Scholar 

  17. Fusco F,. Rizzoli E, Imbimbo C, Rossi, Verze AP, Mirone V . A new era in the treatment of erectile dysfunction: chronic phosphodiesterase type 5 inhibition. Br J Urol Int 2010; 105: 1634–1639.

    Article  CAS  Google Scholar 

  18. Lue TF . Erectile dysfunction. N Engl J Med 2000; 342: 1802–1813.

    Article  CAS  Google Scholar 

  19. Moreland RB . Pathophysiology of erectile dysfunction: the contributions of trabecular structure to function and the role of functional antagonism. Int J Impot Res 2000; 12: S39–S46.

    Article  Google Scholar 

  20. Burchardt M, Burchardt T, Baer L, Kiss AJ, Pawar RV, Shabsigh A et al. Hypertension is associatedwith severe erectile dysfunction. J Urol 2000; 164: 1191–2000.

    Google Scholar 

  21. Jeremy J Y, Angelini G D, Khan M, Mikhailidis DP, Morgan RJ, Thompson CS et al. Platelets, oxidant stress and erectile dysfunction: an hypothesis. Cardiovasc Res 2000; 46: 50–54.

    Article  CAS  Google Scholar 

  22. Jin L, Lagoda G, Leite R, Webb RC, Burnett AL . NADPH oxidase activation: a mechanism of hypertension-associated erectile dysfunction. J Sex Med 2008; 5: 544–551.

    Article  CAS  Google Scholar 

  23. Kloner R . Erectile dysfunction and hypertension. Int J Impot Res 2007; 19: 296–302.

    Article  CAS  Google Scholar 

  24. Montorsi P, Montorsi F, Schulman CC . Is erectile dysfunction the ”tip of the lce berg” of a systemic vascular disorder? Eur Urol 2003; 44: 352–354.

    Article  Google Scholar 

  25. Vlachopoulos C, Aznaouridis K, Ioakeimidis N, Rokkas K, Tsekoura D, Vasiliadou C et al. Arterial function and intima-media thickness in hypertensive patients with erectile dysfunction. J Hypertens 2008; 26: 1829–1836.

    Article  CAS  Google Scholar 

  26. Burchardt M, Burchardt T, Baer L, Kiss AJ, Pawar RV, Shabsigh A et al. Hypertension is associated with severe erectile dysfunction. J Urol 2000; 164: 1188–1191.

    Article  CAS  Google Scholar 

  27. Giuliano FA, Leriche A, Jaudinot EO, De Gendre AS . Prevalence of erectile dysfunction among 7689 patients with diabetes or hypertension, or both. Urology 2004; 54: 1196–1201.

    Article  Google Scholar 

  28. Mittawae B, El-Nashaar AR, Fouda A, Magdy M, Shamloul R . Incidence of erectile dysfunction in 800 hypertensive patients: a multicenter Egyptian national study. Urology 2006; 67: 575–578.

    Article  Google Scholar 

  29. Kloner R . Erectile dysfunction and hypertension. Int J Impot Res 2007; 19: 296–302.

    Article  CAS  Google Scholar 

  30. Lamina S, Okoye CG, Dagogo TT . Managing erectile dysfunction in hypertension: the effects of a continuous training programme on biomarker of inflammation. Br J Urol Int 2009; 103: 1218–1221.

    Article  Google Scholar 

  31. Eaton CB, Liu YL, Mittleman MA, Miner M, Glasser DB, Rimm EB . A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men. Int J Impot Res 2007; 19: 218–225.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S Azab.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Azab, S., Aoud, H. & Nabil, N. The correlation between high sensitivity C-reactive protein and erectile dysfunction patients with hypertension treated with vardenafil. Int J Impot Res 29, 82–85 (2017). https://doi.org/10.1038/ijir.2016.51

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijir.2016.51

Search

Quick links