| Summary: | Purpose: Erectile dysfunction (ED) is an independent predictor of future cardiovascular (CV) events. Aortic pressures (central) and low testosterone independently predict future CV events and mortality. The relationship between testosterone, central pressures and wave reflection indices in ED patients is unknown.
Methods: Total testosterone (TT) levels were measured in 407 consecutive ED patients (55 ± 8 y/o) without CVD. Central (aortic) systolic and pulse pressure, augmentation index (AIx) and augmented pressure (AP) as indices of pulse wave amplification across the arterial tree were measured with SphygmoCor device (AtCor Medical).
Results: TT levels were inversely correlated with systolic and pulse central pressures (r = −0.195 and r = −0.249, respectively) and wave reflection indices (AIx: r = −0.208 and AP: r = −0.168) (all P < 0.001). In multivariate regression models adjusting for age and risk factors, TT was an independent predictor of central pressures and wave reflection indices (all P < 0.001). The combination of low TT level (<4.0 ng/ml) with higher central pulse pressure (>40 mmHg) and AIx (>27%) values showed greater effect on 10-year risk of a CV event (figure).
Conclusions: Our study is the first, to the best of our knowledge, to demonstrate in ED patients the independent association of low testosterone with central pressures and indices of pulse wave amplification across the arterial tree. This observation highlights the role of testosterone as a marker of arterial disease and predictor of CV events and imply a pathophysiological contribution of testosterone deficiency to age and blood pressure-related processes associated with generalized arterial disease.
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