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                 <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed subgroup analyses from the Systolic Blood Pressure Intervention Trial ([SPRINT]; ClinicalTrials.gov: NCT120602, in a sample of 1255 men aged 50 years or older with hypertension and increased cardiovascular disease risk. Participants were randomly assigned to an intensive treatment group (SBP goal of &amp;lt;120 mmHg) or a standard treatment group (SBP goal of &amp;lt;140 mmHg).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure<\/jats:title>\n                    <jats:p>The main outcome measure was change in erectile function from baseline, using the 5-item International Index of Erectile Function (IIEF-5) total score, and erectile dysfunction ([ED]; defined as IIEF-5 score \u226421) after a median follow-up of 3 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At baseline, roughly two-thirds (66.1%) of the sample had self-reported ED. At 48 months after randomization, we determined that the effects of more intensive blood pressure lowering were significantly moderated by race-ethnicity (p for interaction = 0.0016), prompting separate analyses stratified by race-ethnicity. In non-Hispanic whites, participants in the intensive treatment group reported slightly, but significantly better change in the IIEF-5 score than those in the standard treatment group (mean difference = 0.67; 95% CI = 0.03, 1.32; P = 0.041). In non-Hispanic blacks, participants in the intensive group reported slightly worse change in the IIEF-5 score than those in the standard group (mean difference = \u22121.17; 95% CI = \u22121.92, \u22120.41; P = 0.0025). However, in non-Hispanic whites and non-Hispanic blacks, further adjustment for the baseline IIEF-5 score resulted in nonsignificant differences (P &amp;gt; 0.05) according to the treatment group. In Hispanic\/other participants, there were no significant differences in change in the IIEF-5 score between the two treatment groups (P = 0.40). In a subgroup of 280 participants who did not report ED at baseline, the incidence of ED did not differ in the two treatment groups (P = 0.53) and was without interaction by race-ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Implications<\/jats:title>\n                    <jats:p>The effect of intensive treatment of blood pressure on erectile function was very small overall and likely not of great clinical magnitude.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strength &amp; Limitations<\/jats:title>\n                    <jats:p>Although this study included a validated measure of erectile function, testosterone, other androgen, and estrogen levels were not assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a sample of male patients at high risk for cardiovascular events but without diabetes, targeting a SBP of less than 120 mm Hg, as compared with less than 140 mm Hg, resulted in statistically significant effects on erectile function that differed in accordance with race-ethnicity, although the clinical importance of the differences may be of small magnitude.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.jsxm.2019.11.256","type":"journal-article","created":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T22:00:02Z","timestamp":1576620002000},"page":"238-248","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effect of Intensive vs Standard Blood Pressure Treatment Upon Erectile Function in Hypertensive Men: Findings From the Systolic Blood Pressure Intervention Trial"],"prefix":"10.1093","volume":"17","author":[{"given":"Capri G.","family":"Foy","sequence":"first","affiliation":[{"name":"Division of Public Health Sciences , Winston-Salem, NC , USA"},{"name":"Department of Social Sciences and Health Policy , Winston-Salem, NC , USA"},{"name":"Wake Forest School of Medicine , Winston-Salem, NC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill C.","family":"Newman","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences , Winston-Salem, NC , USA"},{"name":"Department of Biostatistic and Data Science , Winston-Salem, NC , USA"},{"name":"Wake Forest School of Medicine , Winston-Salem, NC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg B.","family":"Russell","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences , Winston-Salem, NC , USA"},{"name":"Department of Biostatistic and Data Science , Winston-Salem, NC , USA"},{"name":"Wake Forest School of Medicine , Winston-Salem, NC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan R.","family":"Berlowitz","sequence":"additional","affiliation":[{"name":"Bedford VA Hospital, Bedford, MA, and Boston University School of Medicine and Boston University School of Public Health , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Bates","sequence":"additional","affiliation":[{"name":"Michael E. 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