Hypertension and sexual dysfunction: time to act

Viigimaa, Margus; Doumas, Michael; Vlachopoulos, C.; Anyfanti, Panagiota; Wolf, Jacek; Narkiewicz, Krzysztof; Mancia, Giuseppe

doi:10.1097/hjh.0b013e328342c659

Cited by 78 publications

(48 citation statements)

References 53 publications

(50 reference statements)

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“…A recent double-blind randomised study among 1549 patients in which 400 participants received ramipril, 395 telmisartan and 381 a combination of the two, no benefits of ARBs on erectile dysfunction were proven [55]. It was noted, however, that ARBs were added on top of the previous multidrug regime in high-risk patients and thus conclusions regarding the effects of ARB monotherapy cannot be drawn [56]. In recent randomised trials, irbesartan use after nerve-sparing prostatectomy in patients with normal preoperative erectile function was shown to improve erectile function recovery [57].…”

Section: Resultsmentioning

confidence: 99%

A review of the positive and negative effects of cardiovascular drugs on sexual function: a proposed table for use in clinical practice

et al. 2013

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Several antihypertensive drugs, such as diuretics and β-blockers, can negatively affect sexual function, leading to diminished quality of life and often to noncompliance with the therapy. Other drug classes, however, such as angiotensin II receptor blockers (ARBs) are able to improve patients’ sexual function. Sufficient knowledge about the effects of these widely used antihypertensive drugs will make it possible for cardiologists and general practitioners to spare and even improve patients’ sexual health by switching to different classes of cardiac medication. Nevertheless, previous data (part I) indicate that most cardiologists lack knowledge about the effects cardiovascular agents can have on sexual function and will thus not be able to provide the necessary holistic patient care with regard to prescribing these drugs. To be able to improve healthcare on this point, we aimed to provide a practical overview, for use by cardiologists as well as other healthcare professionals, dealing with sexual dysfunction in their clinical practices. Therefore, a systematic review of the literature was performed. The eight most widely used classes of antihypertensive drugs have been categorised in a clear table, marking whether they have a positive, negative or no effect on sexual function.

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Section: Resultsmentioning

confidence: 99%

A review of the positive and negative effects of cardiovascular drugs on sexual function: a proposed table for use in clinical practice

et al. 2013

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“…One telephone survey of ED prevalence in Taiwan reported that nearly thirty percent of men over 30 years had ED [4]. This medical problem has been associated with endothelial dysfunction and low-grade vascular inflammation and often clusters with hypertension, diabetes mellitus, hyperlipidemia, obesity, and metabolic syndrome [5], [6], [7]. In addition, it has been reported ED as an independent risk factor for macrovascular diseases such as coronary heart disease, cerebrovascular disease (CVD), and peripheral artery disease [8], [9], [10], [11], [12], [13].…”

Section: Introductionmentioning

confidence: 99%

Erectile Dysfunction and Risk of End Stage Renal Disease Requiring Dialysis: A Nationwide Population-Based Study

et al. 2014

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BackgroundPrevious studies have suggested that erectile dysfunction (ED) is an independent risk factor for macrovascular disease. Very few studies have evaluated the relationship between ED and risk of end stage renal disease (ESRD) requiring dialysis.MethodsA random sample of 1,000,000 individuals from Taiwan's National Health Insurance database was collected. We selected the control group by matching the subjects and controls by age, diabetes, hypertension, coronary heart disease, hyperlipidemia, area of residence, monthly income and index date. We identified 3985 patients with newly-diagnosed ED between 2000 and 2008 and compared them with a matched cohort of 23910 patients without ED. All patients were tracked from the index date to identify which patients subsequently developed a need for dialysis.ResultsThe incidence rates of dialysis in the ED cohort and comparison groups were 10.85 and 9.06 per 10000 person-years, respectively. Stratified by age, the incidence rate ratio for dialysis was greater in ED patients aged <50 years (3.16, 95% CI: 1.62–6.19, p = 0.0008) but not in aged 50–64 (0.94, 95% CI: 0.52–1.69, p = 0.8397) and those aged ≧65 (0.69, 95% CI: 0.32–1.52, p = 0.3594). After adjustment for patient characteristics and medial comorbidities, the adjusted HR for dialysis remained greater in ED patients aged <50 years (adjusted HR: 2.08, 95% CI: 1.05–4.11, p<0.05). The log-rank test revealed that ED patients <50-years-old had significantly higher cumulative incidence rates of dialysis than those without (p = 0.0004).ConclusionPatients with ED, especially younger patients, are at an increased risk for ESRD requiring dialysis later in life.

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“…PDE-5 inhibitors are safe and effective in these patients even with simultaneous multidrug antihypertensive therapy. However they are contraindicated in patients treated with short or long acting nitrates and caution is advised with simultaneous alpha-blocking agents (orthostatic hypertension) (27). …”

Section: Cvd Hypertension and Smokingmentioning

confidence: 99%

Erectile dysfunction therapy in countries where implant is economically not feasible

Garza-Gangemi

Zavaleta

2017

Transl. Androl. Urol.

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Erectile dysfunction (ED), a frequent complaint in the primary care setting, is strongly associated with obesity, cigarette smoking and other common cardiovascular risk factors like hypertension, diabetes mellitus (DM), lipid disorders and the metabolic syndrome. The prevalence of these cardiovascular disorders is rising at staggering rates in most Latin American countries. ED is a symptom that mainly affects economically productive men (40–70 years of age) potentially causing major psychosocial repercussions and reduced quality of life. The management of ED in these developing countries is increasingly challenging due to poor patient education and non-adherence to the medical treatment of theses concomitant comorbidities. The financial implications of commonly prescribed medications and surgical procedures limit their use to a minority of patients. For this reason, the clinician must adopt a holistic approach in the management of this disease focusing on preventive measures based on patient education and non-surgical interventions. This review summarizes common associated risk factors of ED and outlines non-pharmacological interventions for the management of this disease.

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Hypertension and sexual dysfunction: time to act

Cited by 78 publications

References 53 publications

A review of the positive and negative effects of cardiovascular drugs on sexual function: a proposed table for use in clinical practice

A review of the positive and negative effects of cardiovascular drugs on sexual function: a proposed table for use in clinical practice

Erectile Dysfunction and Risk of End Stage Renal Disease Requiring Dialysis: A Nationwide Population-Based Study

Erectile dysfunction therapy in countries where implant is economically not feasible

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