A Review on Erectile Dysfunction Among Hypertensive Patients on Pharmacotherapy

Abstract

Hypertension and its related disorders have a high mortality as well as morbidity and require strict adherence to medications in order to mitigate these consequences. Sexual dysfunction is prevalent among patients with hypertension and can either be attributed to the disease progression or as a result of antihypertensive medications. Most patients report the symptoms after initiation therapy and sometimes leads to a spurious association with antihypertensive drugs. However, most drugs in the antihypertensive classes have been associated with sexual dysfunction in both men and women. The most implicated drugs are diuretics, beta-blockers, and centrally acting agents while angiotensin modulating drugs have proved to improve upon erectile dysfunction. The older generation of antihypertensive medications tends to have a negative impact on sexual performance. Females experience sexual dysfunction associated with hypertension and its treatment, but this is grossly under-reported compared to their male counterparts. The incidence in females is higher compared to men and it is sometimes erroneously considered as part of the post-menopausal period rather than hypertension. The impact of medications on sexual dysfunction has somewhat produced contrasting results with some studies showing an association with medications and others proving otherwise. Clinicians need to be aware of the impact of sexual dysfunction among hypertensive patients in order to make an informed decision regarding dosage and choice of medications while keeping target blood pressure in mind.