Journal Article

Sexual function, satisfaction, and association of erectile dysfunction with cardiovascular disease and risk factors in cardiovascular high-risk patients: Substudy of the ONgoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNT Study in ACE-INtolerant Subjects with Cardiovascular Disease (ONTARGET/TRANSCEND)

Baumhäkel, Magnus, Koon, Teo, Zhao, Feng, Yusuf, Salim, Böhm, Michael, Probstfield, Jeffrey L., Schmieder, Roland

2007

Overview

Erectile dysfunction (ED) is a common disorder in middle-aged men and is significantly influenced by cardiovascular risk factors (CVRFs) and cardiovascular disease. The substudy of the ONTARGET/TRANSCEND trials evaluates the relationship of erectile function to baseline characteristics and current treatment in cardiovascular high-risk patients who have been enrolled in these trials. The effects of treatment with telmisartan and ramipril, alone or in combination, including a telmisartan versus placebo arm will be determined prospectively during a follow-up of 4 years. One thousand three hundred fifty-seven patients were evaluated in 13 countries at baseline, 2 years, and 4 years, with ED determined using the ED score of the Cologne Male Survey (Kölner [Cologne] Evaluation of Erectile Dysfunction) and the 5-item International Index of Erectile Function. Erectile dysfunction scores were related to CVRF and the use of cardiovascular drugs. Prevalence of ED was 50.7% (Kölner [Cologne] Evaluation of Erectile Dysfunction) and 54.3% (5-item International Index of Erectile Function), respectively, with a decline of sexual activity after the diagnosis of cardiovascular disease. In multivariate analysis, diabetes mellitus ( P < .00001), stroke ( P = .00026), pelvic surgery ( P = .025), and age of >65 years ( P < .00001) correlated with the degree of ED. No significant associations were observed for cholesterol levels, hypertension, and smoking status as well as current treatment with angiotensin-converting enzyme inhibitors, angiotensin I antagonists, diuretics, β-blockers, or calcium-channel blockers. The ONTARGET/TRANSCEND-ED substudy shows a significant influence of cardiovascular disease on erectile function. In contrast to prior smaller studies, drug therapy and CVRF seem to play a minor role in cardiovascular high-risk patients. Follow-up data will provide information whether angiotensin-converting enzyme inhibitors, angiotensin I antagonists, or a combination thereof are able to improve erectile function.

• Publisher: Mosby, Inc,Elsevier,Elsevier Limited
• Subject: Aged / Aging / Angiotensin-Converting Enzyme Inhibitors - administration & dosage / Angiotensin-Converting Enzyme Inhibitors - adverse effects / Atherosclerosis (general aspects, experimental research) / Benzimidazoles - administration & dosage / Benzoates - administration & dosage / Biological and medical sciences / Blood and lymphatic vessels / Cardiology. Vascular system / Cardiovascular / Cardiovascular disease / Cardiovascular Diseases - drug therapy / Cardiovascular Diseases - epidemiology / Drug therapy / Drug Therapy, Combination / Erectile Dysfunction - epidemiology / Global Health / Humans / Male / Medical sciences / Men / Middle Aged / Multivariate Analysis / Patient Satisfaction - statistics & numerical data / Prospective Studies / Ramipril - administration & dosage / Risk Factors