P3.03 IMPACT OF SMOKING ON ERECTILE FUNCTION AND ARTERIAL STIFFNESS IN MIDDLE-AGED SMOKERS WITHOUT OTHER MAJOR CARDIOVASCULAR RISK FACTORS

Abstract

Purpose: Erectile dysfunction (ED) may be an early manifestation of generalized vascular disease. Cigarette smoking is an important modifiable cardiovascular risk factor and pathophysiological mechanisms may include a stiff vascular tree. The association of smoking with ED and functional changes in smokers without clinical atherosclerosis has not been defined yet. Methods: 56 smokers without other major risk factors and with no clinical atherosclerosis who suffered from ED and 49 smokers without ED, matched for age, body mass index, systolic and diastolic blood pressure were studied. ED diagnosis and score were evaluated according to the International Index of Erectile Function (IIEF) questionnaire. Lower IIEF score indicates severe ED. Carotid-femoral Pulse Wave Velocity (PWV) was measured as an index of aortic stiffness and Augmentation Index (AIx) as a measure of wave reflections. Results: PWV was higher in patients with ED than in the control group (left figure); AIx did not differ (26.7 vs 25.6%, p=NS). A linear inverse relationship between PWV and IIEF score was observed (r=-0.39, p<0.01). In ED patients, smoking more than 40 pack years of cigarettes was associated with a significant decrease in IIEF score and higher PWV values (middle and right figure). Conclusions: Aortic elastic properties but not wave reflections are impaired in current smokers with ED compared to men without ED. ED patients who reported smoking more than 40 pack years had a significant impairment of erectile function and aortic elastic properties. This finding suggests that this group of patients may be at greater cardiovascular risk.