Pd52-12 the impact of hypertension and antihypertensives on semen quality

You have accessJournal of UrologyInfertility: Evaluation1 Apr 2015PD52-12 THE IMPACT OF HYPERTENSION AND ANTIHYPERTENSIVES ON SEMEN QUALITY David Guo, Shufeng Li, Barry Behr, and Michael Eisenberg David GuoDavid Guo More articles by this author , Shufeng LiShufeng Li More articles by this author , Barry BehrBarry Behr More articles by this author , and Michael EisenbergMichael Eisenberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1786AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Approximately 15% of couples are affected by infertility, with 50% of cases involving the male factor. Thus it is important to screen for conditions that may impact male fertility. Given the high prevalence of hypertension in the United States, we examined the relationship between hypertension and its treatment on semen quality. METHODS Data was collected from men evaluated at a tertiary fertility center between 2007 and 2014. The cohort was linked to electronic medical records and insurance claims to obtain diagnosis, vital signs, laboratory, and pharmacy data. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg per ATP III guidelines. Antihypertensive medications were classified as beta blockers (BBs), angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), and diuretics. Semen parameters were assessed by WHO 5th edition criteria. All analyses were adjusted for age, BMI, and year of evaluation. RESULTS In men with an ICD-9 diagnosis of hypertension, 55% had one or more semen abnormalities, compared to 44% of men without hypertension (p=0.02). Using blood pressure data directly, no association was observed between SBP and semen quality. In contrast, elevated DBP was associated with several impaired semen parameters: 25% of men with elevated DBP had semen volume <1.5 mL (vs 17% of men with normal DBP, p<0.01), 39% had a total sperm count<39 M (vs 26%, p=<0.01) and 40% had a total motile sperm count<9 M (vs 28%, p<0.01). Use of antihypertensive medications was associated with a variety of semen abnormalities. Men who were taking BBs had significantly lower semen volume (1.98 vs. 2.95 mL), sperm concentration (30.6 vs. 62.4 M/mL), and sperm motility (35.3% vs. 43.4%) compared to men who were not taking BBs (p<0.01). Isolated differences were observed in men who were taking CCBs, ACE inhibitors and ARBs, while no significant differences were seen in men taking diuretics. CONCLUSIONS There is an association between hypertension and impaired semen quality. When examining blood pressure directly, diastolic, but not systolic pressure, appears to drive this relationship. Importantly, certain medications for hypertension, particularly beta blockers, are also associated with impaired semen parameters. Given the high prevalence of hypertension and its treatment, further investigation is warranted. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1117 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Guo More articles by this author Shufeng Li More articles by this author Barry Behr More articles by this author Michael Eisenberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...