Purpose: Erectile dysfunction (ED) is very common in men with hypertension. Increased arterial stiffness and clinical evidence of ED are both associated with atherosclerosis process. We examined the possible correlations between large artery stiffening and ED severity in essential hypertensive patients.

Methods: Our population of 140 non-diabetic patients with vasculogenic ED and stage I to II essential hypertension was divided into three groups according to carotid-femoral pulse wave velocity (PWV) values, by means of an automated non-invasive device. Group A (PWV< 8.1 m/sec), group B (PWV =8.2–9.4 m/sec) and group C (PWV >9.5 m/sec). Pharmacologically stimulated peak systolic velocity (PSV) of cavernous arteries was used to assess penile vascular damage.

Results: Patients in group C (n=42) compared to subjects in group A (n=55) and B (n=43) had higher systolic BP (P<0.01 for all) and longer duration of essential hypertension (P<0.05 for all). Moreover, patients in group C had longer duration of ED (3.3 ± 1.7 vs 2.8 ± 1.5 vs 1.7 ± 1.2 years, respectively; P<0.05 for all) and lower PSV (29 ± 8 vs 32 ± 10 vs 36 ± 10 cm/s, respectively; P<0.05 for all). In the total population, PWV was correlated with PSV (r=−0.29, P<0.01), while PSV was associated with systolic BP (r=−0.18, P<0.05) and pulse pressure (r=−0.23, P<0.05). Analysis of covariance revealed that PSV and ED duration remained significantly different between groups after adjustment for confounding factors (P<0.05).

Conclusions: In men with ED and essential hypertension, there is an augmentation in penile inflow insufficiency and longer duration of ED throughout increasing PWV tertiles. These findings suggest that arterial stiffening is closely related to ED processes, in this setting.