A 58-year-old man with hypertension and a 3-year history of erectile dysfunction presents to his cardiologist, who initiates lisinopril 10 mg daily. Vital signs show BP 148/92 mmHg, HR 78/min, RR 16/min. After 6 weeks, his erectile function improves significantly. Serum creatinine is 0.9 mg/dL, potassium is 4.2 mEq/L, and fasting glucose is 98 mg/dL. Physical examination reveals no peripheral edema. He denies chest pain or dyspnea. Which of the following best explains the mechanism by which ACE inhibitors improve erectile function in this patient?
- A)ACE inhibitors block muscarinic receptors in the corpus cavernosum
- B)ACE inhibitors increase dopamine release from the hypothalamus
- C)ACE inhibitors directly stimulate phosphodiesterase-5 in corpus cavernosum
- D)ACE inhibitors increase sympathetic activity to improve penile tumescence
- E)ACE inhibitors reduce angiotensin II-mediated vasoconstriction, allowing improved penile blood flow and nitric oxide signalingGABARITO
Explicação
Angiotensin II promotes vasoconstriction and impairs endothelial function. ACE inhibitors reduce angiotensin II levels, decreasing vasoconstriction and improving endothelial nitric oxide bioavailability. This allows better vasodilation and penile blood flow, f... Ver explicação completa e trilha adaptativa →