Male Sexual DysfunctionResponse to On-demand Vardenafil was Improved by its Daily Usage in Hypertensive Men
Section snippets
Study Population
Sexually active men aged between 50 and 70 years were selected from the Outpatient Hypertension Clinic at the State University of Rio de Janeiro over a 12-month period. Inclusion criteria were essential hypertension, moderate to severe ED with no evidence of major cardiovascular disease, and nonresponsiveness to at least 4 sexual attempts with 20 mg of vardenafil. ED severity was classified according to a self-administered and validated questionnaire: the International Index of Erectile
Results
From 284 hypertensive patients initially screened, we first selected 74 men who were sexually active, heterosexual, with a stable partner for more than 6 months, no evidence of major cardiovascular disease, and no changes in baseline medication for the last 6 months. All 74 patients met criteria for ED for ≥6 months and had less than 50% positive answers on SEP-3 without medications. They tried 20 mg of on-demand vardenafil in at least 4 attempts. Thirty-five individuals were considered
Comment
In this study, the main result shows that continuous use of vardenafil taken nightly during 5 weeks improved erectile function among men with ED and hypertension with no major cardiovascular disease who did not respond to previous on-demand regimen. To date, there are few studies in the literature that clarify the clinical efficacy of continuous regimens in such populations and none, to our knowledge, with an adequate design or a homogenous sample that allows external validation.
The therapeutic
Conclusions
In conclusion, in this sample of hypertensive men with ED and no other clinical evidence of atherosclerosis who did not respond to on-demand PDE-5 inhibitor, the use of continuous vardenafil was able to improve erectile function. This beneficial effect was not observed in patients with diabetes. Continuous PDE-5 effectiveness was associated with sexual frequency and LDL-cholesterol levels. Despite these findings, further clinical trials are necessary to confirm the beneficial effects of
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Cited by (8)
Pharmacotherapy for Erectile Dysfunction: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015)
2016, Journal of Sexual MedicineCitation Excerpt :There also is clear evidence that vardenafil is efficacious in the treatment of ED in special populations of men with ED. These populations include men with (i) diabetes and ED189–191 (consistent level 1 studies), (ii) ED secondary to radical retropubic prostatectomy192 (single level 1 study), (iii) depression and ED193 (single level 1 study), (iv) hypertension and ED194 (single level 1 study and single level 2 study),188 (v) spinal cord injury and ED195 (single level 1 study), (vi) hyperlipidemia and ED196 (single level 1 study), (vii) previous failed responses to sildenafil197 (single level 1 study and single level 2 study),198 (viii) metabolic syndrome199 (single level 1 study), (ix) previous failed responses to on-demand vardenafil 20 mg treated with daily dosing of vardenafil 10 mg plus 10 mg before intercourse200 (single level 2 study), (x) renal transplantation201 (single level 2 study), (xi) schizophrenia202 (single level 2 study), and (xii) end-stage renal disease treated with hemodialysis94 (single level 2 study). There is consistent evidence that vardenafil not only is efficacious in the treatment of ED but also significantly improves several psychosocial outcomes.
Practical approaches to treat ED in PDE5i nonresponders
2020, Aging and DiseaseTwo Birds with One Stone: Regular Use of PDE5 Inhibitors for Treating Male Patients with Erectile Dysfunction and Cardiovascular Diseases
2019, Cardiovascular Drugs and TherapyManagement of erectile dysfunction: An under-recognition of hypertension
2018, Current Pharmaceutical Design
Financial Disclosure: The authors declare that they have no relevant financial interests.