Feng Zhao

Effect of felodipine with irbesartan or metoprolol on sexual function and oxidative stress in women with essential hypertension.

Objective To evaluate the impact of felodipine with irbesartan on sexual function compared with felodipine with metoprolol in hypertensive women. Methods This was a prospective, randomized, parallel, active-controlled, open-label study (ClinicalTrials.org: NCT01238705) in 160 women (18–60 years) with mild or moderate hypertension, randomized to a once-daily treatment with felodipine combined with irbesartan or metoprolol for 48 weeks. Patients’ sexual function was evaluated using a female sexual function index (FSFI) questionnaire at baseline and after 24 and 48 weeks of therapy. Levels of serum estradiol, testosterone, 8-hydroxy-2’-deoxyguanosine (8-OHdG), 4-hydroxynonenal (4-HNE) and malondialdehyde (MDA) were measured. Results The two combination regimens were similarly effective in lowering blood pressure. After 48 weeks, in felodipine–irbesartan group, total scores of FSFI improved (P < 0.001). Items showing improvement in scores corresponded to desire, arousal and orgasm (P < 0.001; P = 0.002; P = 0.049, respectively). Levels of estradiol increased under treatment with felodipine–irbesartan (P = 0.003) and decreased under felodipine–metoprolol treatment (P < 0.001). The concentration of testosterone declined after felodipine–irbesartan therapy (P < 0.001) and increased under felodipine–metoprolol treatment (P < 0.001). In the felodipine–irbesartan group, decreases of 8-OHdG, 4-HNE (P < 0.001) and MDA (P < 0.001) were observed. The felodipine–irbesartan combination resulted in less oxidative stress. The differences in changes in 8-OHdG, 4-HNE and MDA between the two groups were significant (P < 0.05). Conclusion These results suggested that the felodipine–irbesartan combination regimen improved sexual function in hypertensive women, whereas felodipine–metoprolol regiment did not. The reason for the different influence of these two combination therapy on female sexual function might be their different impacts on oxidative stress and hormone levels.

The Effect of Combined Antihypertensive Treatment (Felodipine with Either Irbesartan or Metoprolol) on Erectile Function: A Randomized Controlled Trial

Objectives: This study aimed to determine whether combining a calcium channel blocker with either an angiotensin II receptor blocker or a β-blocker would have similar effects on sexual function in men with hypertension. Methods: This prospective, randomized study (ClinicalTrials.gov: NCT01238705) included 218 male participants with untreated hypertension. Patients were randomized to treatment with felodipine combined with irbesartan or metoprolol for 48 weeks. Sexual function was evaluated at baseline and after 48 weeks of therapy. The levels of serum sex hormones and markers of oxidative stress were measured at the same time. Results: There was no significant difference in the prevalence of erectile dysfunction before and after treatment in either group (p > 0.05). There were also no differences in the levels of serum testosterone, sex hormone-binding globulin or 4-hydroxynonenal before and after treatment in either group (p > 0.05). In the felodipine-irbesartan group, sexual desire scores rose after treatment (p = 0.022) and the concentrations of serum 8-hydroxy-2′-deoxyguanosine and malondialdehyde declined (p < 0.001 and p = 0.002, respectively). The between-group differences for 8-hydroxy-2′-deoxyguanosine and malondialdehyde were not significant (p > 0.05, respectively). Conclusion: The results suggest that felodipine-irbesartan may be more beneficial to the sexual desire of hypertensive male patients than felodipine-metoprolol. This effect was possibly relevant to irbesartan, which prevents oxidative stress to some extent.

1073 CHANGES IN FEMALE HORMONE LEVELS UNDER DIFFERENT ANTIYPERTENSIVE COMBINATION THERAPY: ROLE OF OXIDATIVE STRESS

Background: Oxidative stress is involved in the pathogenesis of essential hypertension. Estrogen has long been recognized to offer cardiac benefit and vascular protection against atherosclerosis. Thus, this randomized controlled study aimed to test the hypothesis that antihypertensive treatment could attenuate sex hormone levels by modulating oxidative stress in hypertensive women. Methods: One hundred and fifty one women (23-60 years) with mild or moderate hypertension, randomized to a once daily treatment with felodipine combined with irbesartan or metoprolol for 48 weeks. Levels of serum estradiol, testosterone, 8-Hydroxy-2’-deoxyguanosine (8-OHdG), 4-hydroxynonenal (4-HNE) and malondialdehyde (MDA) were measured at baseline and after 24-weeks and 48-weeks of therapy. Results: The two combination regimens were similarly effective in lowering blood pressure. After 48 weeks, in felodipine-irbesartan group, levels of estradiol increased under treatment (P = 0.003) and decreased under felodipine-metoprolol treatment (P < 0.001). As shown in Table 1. the concentration of testosterone declined after felodipine-irbesartan therapy (P < 0.001) and increased under felodipine-metoprolol treatment (P < 0.001). In the felodipine-irbesartan group, decreases of 8-OHdG, 4-HNE (P < 0.001) and MDA (P < 0.001) were observed. The felodipine-irbesartan combination resulted in less oxidative stress. The differences in changes in 8-OHdG, 4-HNE and MDA between the two groups were significant (P < 0.05). Correlation was found between changes in levels of 8-OHdG, 4-HNE and MDA with estradiol (P < 0.05 for all). TABLE 1 Serum estradiol and testosterone at baseline, 24 weeks and 48 weeks in two groups Data are shown as mean ± SD. F+I, Felodipine 5-10 mg + irbesartan 150 mg. F+M, Felodipine Conclusions: The data suggest that the felodipine-irbesartan combination regimen help maintain estradiol in hypertensive women, whereas felodipine-metoprolol regimen did not. Oxidative stress reduction may be one mechanism.

E-011 THE RELATIONSHIP BETWEEN OXIDATIVE STRESS AND SEXUAL DYSFUNCTION IN FEMALE PATIENTS WITH HYPERTENSION

Backround Evidencessuggest that female sexual dysfunction(FSD) is more prevalent in hypertensive women than in normotensive women. One possible explanation might be the impacts of hypertension oxidative stress. The aim of this study was to evaluate the relationship between oxidative stress and FSD in hypertensive women. Methods Total of 160 hypertensive (1 or 2 degree) women and 50 normotensive women, aged 18–60 years, were investigated. Hypertensive patients were newly diagnosed, previously untreated no less than one month. Female sexual function was evaluated using a female sexual function index (FSFI) questionnaire. Levels of serum 8-Hydroxy-2’-deoxyguanosine (8-OHdG), 4-hydroxynonenal (HNE) and malondialdehyde (MDA) were measured. Linear regression analysis was used to identify predictors of an abnormal FSFI score with variables associated with it during univariate analysis. Funding from: The Specific Project of Technological Research and Development in Gansu Province of China(0709TCYA068). Results Sexual dysfunction was found in 60.4% of hypertensive women compared with 26.0% of normotensive women (P = 0.000). FSD rates gradually increased in older compared with younger hypertensive women. The mean score of FSFI at baseline decreased with age,and the between-age-groupdifference was statistically significant (P = 0.000). Levels of8-OHdG,HNE and MDA werelower in hypertensive patients compared with normotensive women (P = 0.003,P = 0.001,P = 0.000, respectively). In hypertensive women, levels of 8-OHdG,HNE and MDA did not statistically differ between women with FSD and normal sexual function (P = 0.375, P = 0.452, P = 0.378, respectively). No statistically significant correlation was found between FSFI score and concentration of8-OHdG,HNE and MDA(P = 0.231, P = 0.142, P = 0.104, respectively). Serum 8-OHdG,HNE and MDA were not predictors of FSFI score. Conclusions These results suggest that FSD is more prevalent in women withessential hypertension compared with women with normalblood pressure. Status of oxidative stress is enhanced in hypertensive women. However, no relationship shows between FSD and oxidative stress. This topic need to be explored in the future study.