Association Of The Primary Aldosteronism With Moderate To Severe Erectile Dysfunction

Objective: The present study aimed to compare the prevalence of erectile dysfunction(ED)between patients with primary aldosteronism(PA)and those with essential hypertension(EH),investigate the association of PA with ED and its potential risk factors.Methods: In this cross-sectional study,recruited 102 PA patients and 102age-matched EH patients,who visited the Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region China from February to November 2019,all subjects did not take any antihypertensive drugs,or took verapamil and(or)?-adrenergic antagonists before diagnosis,aged from 20 to 70 years,and volunteered to complete the International Index of Erectile Function 5(IIEF-5)questionnaire.We diagnosed ED and assessed severity based on the IIEF-5 scores.Compared the differences in clinical and biochemical characteristics,sexual hormones,IIEF-5 scores,aldosterone,renin activity,the prevalence of ED between PA and EH groups.According binary logistic regression analysis to demonstrated the association of PA with ED,and determine which parameters significantly increased the odds ratio for ED.Results: Patients with PA had the longer duration of hypertension,more patients used antihypertensive drugs,greater BMI,lower IIEF-5 scores,lower male hormone level(such as: testosterone,dehydroepiandrosterone sulfate,androstenedione)than patients with EH,significantly(P<0.05).PA group had the higher prevalence of ED(75.5% vs 62.7%,P=0.049),especially the difference in prevalence of moderate to severe ED was more remarkable(29.4% vs 14.7%,P=0.011).In recruited hypertension population,the comparison of all possible relevant factors among moderate to severe ED,mild ED and non-ED groups indicated that patients with moderate to severe ED tended to be older,with lower plasma renin activity,higher ARR and proportion of PA.Multivariate logistic regression analysis suggested that PA(odds ratio[OR]: 4.190,95%confidence interval [CI]: 1.366–12.849,P=0.012)associated with moderate to severe ED,after adjusting for known risk factors of ED.Similar statistical methods were applied to the comparison among three different type ED groups in PA patient,both aldosterone-producing adenoma(APA)(OR: 3.878,95%CI: 1.172–12.828,P=0.026)and plasma aldosterone concentration(PAC)?13.03ng/dl(OR: 3.419,95%CI:1.042-11.218,P=0.043)are risk factors of moderate to severe ED,after adjusting for age respectively.Conclusions: PA is associated with moderate to severe ED,especially patients with PA presenting with the APA or PAC?13.03ng/dl are at a greater risk of moderate to severe erectile dysfunction,suggesting that assessment of sexual function in PA patients cannot be ignored,diagnosis of PA and specific treatment are necessary as early as possible.