An elevated plasma aldosterone level has been reported as an independent risk factor for severe erectile dysfunction in men. The aim of this study was to explore whether primary hyperaldosteronism patients experience erectile dysfunction after targeted treatment.
We conducted a population-based cohort study of men with newly identified primary hyperaldosteronism/aldosterone-producing adenoma from January 1, 1997, to December 31, 2009. Men with essential hypertension and normotension were matched to the primary hyperaldosteronism group according to propensity score matching.
We identified 1,067 men with primary hyperaldosteronism (mean age, 46.7 ± 12.8 years) and matched them with the same number of men with essential hypertension or normotension. During the mean follow-up interval of 5.4 years, the incident rates of total erectile dysfunction were 5.7, 3.9, and 3.1 per 1,000 person-years for the primary hyperaldosteronism, essential hypertension, and normotension groups, respectively. Men with primary hyperaldosteronism exhibited a higher risk of erectile dysfunction compared with men with normotension (competing risks hazard ratio, 1.83), and no difference was seen in comparison with men who have essential hypertension. After adrenalectomy, men who have primary hyperaldosteronism had a higher risk of exhibiting severe erectile dysfunction compared with men who have essential hypertension (competing risks hazard ratio, 2.44) or normotension (competing risks hazard ratio, 2.90).
Men with primary hyperaldosteronism reported a higher incidence of severe erectile dysfunction than normotension controls despite targeted treatment. The risk of severe erectile dysfunction increased after men who have primary hyperaldosteronism underwent adrenalectomy. This result raises the possibility of severe erectile dysfunction after adrenalectomy and calls for a prospective large-scale study of men who have aldosterone-producing adenoma regarding their erectile function both before and after adrenalectomy.
Surgery. 2018 Nov 22 [Epub ahead of print]
Chia-Hui Chang, Shih-Chieh J Chueh, Vin-Cent Wu, Likwang Chen, Yen-Hung Lin, Ya-Hui Hu, Kwan-Dun Wu, Yao-Chou Tsai
Division of Endocrine and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei., Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei; Cleveland Clinic Lerner College of Medicine and Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH., Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei; Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan., Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Division of Endocrine and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan; Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei., Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei; Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan. Electronic address: .