Antihypertensives

Erectile dysfunction is claimed to be a frequent side effect of antihypertensive treatment. Also patients themselves are convinced that their impotence is caused by antihypertensive drugs they take, and many physicians support this opinion; however, as early as 1978 Bauer et al. stated that the extent of sexual function impairment is age-related as compared with that observed in men not taking antihypertensives. Ten year later, Bansal (1988) quoted that the reported studies did not clearly indicate whether the impairment is due to the drugs, the influence of the disease, or both. Again 10 years later, other authors concluded: "Scientific evidence that links antihypertensive drugs to sexual dysfunction in placebo-controlled trials is limited" (Grimm et al. 1997).

Nevertheless, patients with hypertension are at greater risk to suffer from erectile dysfunction, irrespective of the treatment, than are healthy men. The OR was found to be significantly greater than 1 in large case-control studies. The erectile dysfunction was frequently associated with intermittent claudication and ischaemic heart disease.

Diuretics, centrally acting sympatholytic drugs, and ß-blockers appear to bear a greater impact, while calcium antagonists and ACE inhibitors appear to show a lower impact on erectile function (Fogari et al. 2002; Mikhailidis et al. 2000).

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