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Objective

Aim of the study is to examine possible differentiation of microvascular and macrovascular damage among patients with erectile dysfunction (ED) according to cholesterol levels and statin therapy.

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Methods

: We measured carotid intima-media thickness (IMT), carotid-femoral pulse wave velocity (PWV) and penile peak systolic velocity (PSV) 20 min after intracavernous injection of prostaglandin E1 in 356 consecutive ED patients (mean age 57±9 years) without manifest cardiovascular/atherosclerotic disease or diabetes. Biochemical parameters and total testosterone were measured in all patients. Low PSV indicates severe penile vascular disease and increased risk of major cardiovascular events.

Results

95 (26.7%) ED patients are treated with statins. The patients not receiving statin therapy (n=261) were subsequently divided into three groups according to LDL level (group 1: LDL<100 mg/dl, group 2: LDL: 100-155, group 3: LDL >155 mg/dl). The four studied groups have similar age and prevalence of hypertension and smoking. Patients under statin therapy and subjects in group 2 have similar mean LDL level. Carotid IMT was significantly higher in patients with LDL >155 mg/dl (group 3) compared to patients treated with statins (P=0.01) and subjects with LDL:100-155 mg/dl (P=0.005) and LDL<100 mg/dl (P<0.001). Post hoc analysis showed that patients treated with a statin and subjects in group 3 had comparable penile PSV and significantly lower values compared to those of patients in group 1 and group 2 (figure). Carotid-femoral PWV was not different between the four groups. Testosterone levels were not different between patients treated with a statin and males not receiving hypolipidemic therapy (groups 2 and 3).

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