Key result
Primary hyperaldosteronism is linked to ~83% higher erectile dysfunction risk, and severe cases increase post-adrenalectomy.
Why the study?
Elevated aldosterone is an independent risk factor for severe erectile dysfunction, but whether primary hyperaldosteronism patients experience erectile dysfunction after targeted treatment remained unknown.
Does primary hyperaldosteronism and its targeted treatment increase the risk of severe erectile dysfunction compared to essential hypertension or normotension in men?
Cohort (n=3,201)
Does primary hyperaldosteronism and its targeted treatment increase the risk of severe erectile dysfunction compared to essential hypertension or normotension in men?
Hazard Ratio: 1.83
Absolute Event Rate: 5.7% vs 3.1%
Men with primary hyperaldosteronism have an increased risk of severe erectile dysfunction, which paradoxically increases further after adrenalectomy compared to normotensive and essential hypertension controls.
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
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Chang et al. (2018) conducted a cohort in Primary hyperaldosteronism (n=3,201). Primary hyperaldosteronism vs. Normotension was evaluated on Total erectile dysfunction (HR 1.83). Men with primary hyperaldosteronism had a higher risk of erectile dysfunction compared with normotensive men (HR 1.83), and the risk of severe erectile dysfunction increased after adrenalectomy.
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