Sexual dysfunction in hypertensive men. A critical review of the literature.

Abstract

Sexual dysfunction is common in hypertensive men and often is first reported by patients while receiving hypotensive therapy, leading to a widespread belief by patients and physicians that the sexual dysfunction is caused by a specific antihypertensive medication. However, it is unclear from the literature whether this problem is related to hypertension or to its therapy. Further, whether the erectile failures reported during therapy are a result of 1) reduced penile blood flow secondary to reduction of blood pressure after antihypertensive treatment or to obstructive vascular disease (or both) or 2) specific drug effects has not been well studied. Because of these unresolved issues, this common problem is not well managed and contributes to noncompliance with therapy by hypertensive male patients, which impedes the attainment of satisfactory blood pressure control. The present article reviews the literature related to hypertension and sexual function in men and outlines a management strategy for clinicians that attempts to document normalcy of sexual function before initiating treatment in newly diagnosed hypertensive patients. Further, it does not ascribe causality to specific antihypertensive agents for the sexual dysfunction reported by treated hypertensive patients but attempts instead to delineate the pathogenesis of the dysfunction. Once the pathogenesis is established, treatment plans can be implemented to restore normotension and maintain adequate sexual function among treated hypertensive men. The article also discusses how applied research in this area may be performed.

Prevalence of erectile dysfunction and its correlates among men attending primary care clinics in three countries: Pakistan, Egypt, and Nigeria

“…ED is primarily a vascular condition, [15][16][17][18][19][20][21] an etiology supported by our finding of a higher prevalence of ED in men with diabetes, hypertension, and (marginally) with heart disease in ageadjusted bivariate analyses. In the multivariate model, however, only diabetes was independently associated with ED, which was also the case in the Cross-National Study.…”

Prevalence of erectile dysfunction among Chinese men with type 2 diabetes mellitus

“…2,24,[29][30][31][32][43][44][45] Hypertension and vascular disease have been reported to be risk factors for ED. 2,27,28,44,[46][47][48][49] In addition, the prevalence of ED is reported to be higher in men taking certain medications, including hypoglycemic agents, antihypertensive or cardiac drugs, diuretics and antidepressants. 2,[50][51][52][53] We also observed a higher prevalence of ED in patients who had hypertension or cardiovascular disease.…”

Candesartan cilexetil protects cavernous tissue in spontaneously hypertensive rats

“…3,4 Moreover, ED is increased in prevalence in hypertensive patients, and it is highly associated with cardiovascular disease. [5][6][7][8][9] The discussion whether in hypertensive patients, high blood pressure itself or the antihypertensive therapy constitutes a cause of ED has always been a controversial point. Antihypertensive drugs are most commonly associated with ED.…”