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Hypertensive medications sexual function


This review aims to highlight the importance of recognizing erectile dysfunction in patients with hypertension and cardiovascular disease and to provide practical information about the management of erectile dysfunction in treated and untreated hypertensive patients.

Blood pressure elevation per se is associated with an increased occurrence of erectile dysfunction, while successful blood pressure control is associated with erectile function benefits. Accumulating data indicate that antihypertensive drug therapy is associated with erectile dysfunction. Antihypertensive drugs have detrimental diuretics, beta-blockers, centrally acting agentsneutral calcium antagonists, ACE inhibitors or potentially beneficial angiotensin receptor blockers, nebivolol effects on erectile function.

Arterial hypertension is a major cardiovascular risk factor and represents a significant public health problem that affects more than one billion adults and is presumed responsible for almost 7 million deaths each year worldwide [1]. The advent of antihypertensive therapy rendered more than antihypertensive drugs available on the market for the effective management of arterial hypertension. Each therapeutic class targets a specific mechanism involved in the pathogenesis of hypertension and has its own advantages and disadvantages, indications and contraindications.

Scientific advances in recent decades have resulted in the effective management of many diseases, have significantly prolonged the life expectancy of humankind, and uncovered the importance of quality of life as a significant aspect in the management of any patient. Sexuality is an inherent characteristic of human beings and represents a cardinal component of quality of life.

Erectile function is highly appreciated by the majority of males, even at older ages, and erectile dysfunction exerts a major burden on the quality of life not Hypertensive medications sexual function of patients but also of their sexual partners [2]. Erectile dysfunction is frequently encountered in hypertensive men, and the co-existence of arterial hypertension and erectile dysfunction increases with age.

There are several clinically meaningful questions that need to be answered regarding the association between arterial hypertension and erectile dysfunction: This review aims to highlight the importance of recognizing erectile dysfunction in patients with hypertension and cardiovascular disease, to provide practical information about the management of erectile dysfunction in treated and untreated hypertensive patients, and to summarize the efficacy and safety of PDE5 inhibitors in cardiovascular disease.

The importance of searching for and recognizing erectile dysfunction in patients with hypertension lies in four major parameters: Erectile dysfunction is found almost twice as frequently in hypertensive patients compared to normotensive individuals [3,4].

Moreover, erectile dysfunction is highly prevalent in patients with other concomitant cardiovascular risk factors diabetes mellitus, obesity, metabolic syndrome, dyslipidemia or overt cardiovascular disease coronary artery disease, heart failure. Overall, more than half of patients with hypertension suffer from erectile dysfunction and the prevalence of the latter increases with advancing age, the severity and the duration of hypertension, and the presence of other cardiovascular risk factors.

Erectile dysfunction exerts a major impact on the quality of life of patients and their sexual partners. It has to been seen that hypertension is mainly an asymptomatic disease. It is therefore not surprising that patients experiencing sexual problems induced by antihypertensive drugs are "Hypertensive medications sexual function" likely to withdraw or not adhere to antihypertensive therapy than patients free of sexual problems. Finally, erectile dysfunction is of vasculogenic origin, in the vast majority of cases due to atherosclerotic lesions in the penile arteries.

Due to the smaller diameter of penile arteries as compared to coronary arteries, sexual problems tend to appear earlier than symptoms from the heart. Indeed, erectile dysfunction is usually experienced 3 to 5 years before the appearance of symptomatic coronary artery disease. Therefore, erectile dysfunction can be used as an early diagnostic sign of otherwise asymptomatic coronary artery Hypertensive medications sexual function. However, despite the importance of the timely recognition and appropriate management of erectile dysfunction, the latter remains remarkably under-reported, under-recognized, and under-treated [5].

Several patient-related and physician-related factors are responsible for this unpleasant reality. Physicians are also reluctant to initiate a discussion about sexual problems due to lack of familiarity with this issue, mainly due to lack of appropriate training on this topic. In order to address this issue, inthe "Hypertensive medications sexual function" Society of Hypertension formed a Working Group on arterial hypertension and sexual dysfunction, aiming to sensitize physicians about the magnitude of this problem, and educate cardiologists, internists, primary care physicians, and other doctors regarding how to approach patients about sexuality, how to Hypertensive medications sexual function erectile dysfunction, and how to manage these patients.

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