Post Date December, 03 2023
Lao Chen is a typical old Beijing man in his fifties. He doesn't exercise much and doesn't choose to eat, but his body has always been pretty good, with very few colds. He always says to everyone, "I just eat whatever I want, and I don't have any problems." But over the past six months, Lao Chen has become a bit unsure about his own body. Speaking of it, there's nothing else wrong with it, but it's just that in bed there's a bit of "lack of virility.". "Once or twice, Lao Chen didn't care, but later on, the frequency of" not lifting "became more and more frequent. Lao Chen was embarrassed to say that his wife began to quit and urged him to go to the hospital to see a doctor.". "There was no way out, so Chen had to come to a regular tertiary hospital for an examination in the andrology department.". It's good not to check. With this blood pressure measurement, the doctor found that Lao Chen's high pressure was almost 160mmHg.
Men are most afraid of erectile dysfunction (ED). Once it occurs, patients may not only have unsatisfied sexual desires and enjoyment, but also experience mental and psychological disorders as a result, which may further lead to abnormalities in social behavior. However, erectile dysfunction is often the early manifestation of many serious physical diseases, such as coronary heart disease, hypertension, diabetes, etc.
One study showed that erectile dysfunction occurs 53.4 months earlier than symptoms of ischemic heart disease; Erectile dysfunction (ED) occurred in 5 of 10 male patients with hypertension, 9 of 10 male patients with depression, and 4 of 10 male patients with atherosclerosis. ED is closely related to cardiovascular diseases such as hypertension, and it is generally believed that the proportion of hypertension patients with ED exceeds 40%.
Why are the two diseases so closely related? This has to start with the physiological mechanism of penis erection. The erection of the penis must rely on sound neural regulatory function, normal endocrine function, good vasomotor function, and healthy local penile tissue structure. Among the organic causes of ED, the most common is vascular function damage, and the first to suffer from vascular function damage is vascular endothelial cell function damage, which can cause an imbalance in the substances that produce and/or act on the vascular wall to relax and constrict blood vessels, thereby affecting erectile function. In the early stage of hypertension, it is also mainly the pathological changes of vascular endothelial cells.
In addition, ED and hypertension have many similarities in etiology and risk factors. Such as bad lifestyles; Chronic alcoholism and smoking; High fat diet; Excessive pressure in work and life; Chronic mental stress and anxiety; Sleep disorders, among other things, can bring a heavy burden or even damage to blood vessels, with small blood vessels more vulnerable than large ones and more prone to early symptoms. The penis is rich in small blood vessels. Once vascular endothelial cells are damaged, it often first shows that the penis's erectile function is affected, and then the blood vessels of systemic organs are damaged. Currently, clinical medicine has gradually recognized that male erectile dysfunction can often serve as an early warning signal for many serious cardiovascular and cerebrovascular diseases such as hypertension and even myocardial infarction.
Of course, ED can also be a complication of hypertension. About 80% of patients with severe peripheral vascular disease have ED, 64% of patients with myocardial infarction have ED, and 57% of patients undergoing coronary artery bypass surgery have ED. The reason is that long-term hypertension can lead to a decrease in the elasticity of blood vessels, large and small, leading to hardening or stenosis, leading to insufficient blood supply to organs and tissues, and hypoxia; In men, the penis exhibits weakness and inability to erect.
Unfortunately, quite a few of the current types of antihypertensive drugs may directly affect male sexual function. It has been reported that about 25% of patients taking antihypertensive drugs may develop ED, while others may experience decreased libido, decreased sexual responsiveness, or even accompanied by ejaculation disorders. Therefore, patients with high blood pressure and sexual needs must be cautious when choosing antihypertensive drugs, and should not be shy about speaking up. They should explain their needs to doctors. Doctors will choose drugs that have a relatively small impact on penile erectile function, such as ARBA, ACEI, or calcium antagonists, while fully controlling blood pressure.
Among the numerous methods for treating ED, oral PDE5 inhibitors, which are simple, convenient, and have good privacy, and can be taken for a long time, are currently the frontline treatment methods in clinical practice. It can dilate penile blood vessels, relax cavernous smooth muscle, and promote erection; It is an ideal drug for patients with hypertension and ED; At the same time, it does not affect the central nervous system, and therefore does not lead to the side effects such as drug addiction or dependence that patients fear. If a patient develops ED after using a certain type of antihypertensive drug, they can consult a doctor and, if possible, adjust their hypertension medication first, while also assisting in taking PDE5 inhibitors to treat ED.
(Intern Editor: Cai Junyi)
