Sexual Dysfunction: The ‘prima Ballerina’ Of Hypertension-related Quality-of-life Complications
Athanasios Manolis, Michael Doumas
Published 2008 · Medicine
Download PDFAnalyze on Scholarcy
Sexual dysfunction is currently considered a serious quality-of-life-related health problem, exerting a major impact on patients' and their sexual partners' life. Available data indicate that essential hypertension is a risk factor for sexual dysfunction, as male and female sexual dysfunction is more prevalent in hypertensive patients than normotensive individuals. Several mechanisms have been implicated in the pathogenesis of sexual dysfunction in hypertensive patients, and major determinants include severity and duration of hypertension, age, and antihypertensive therapy. Female sexual dysfunction, although more frequent than its male counterpart, remains largely under-recognized. Older antihypertensive drugs (diuretics, β-blockers, centrally acting) exert negative results, whereas newer drugs have either neutral (calcium antagonists, angiotensin-converting enzyme inhibitors) or beneficial effects (angiotensin receptor blockers). Erectile dysfunction is related to ischemic heart disease and might be an ‘early therapeutic window’ of asymptomatic coronary artery disease. It seems of utmost importance for every physician treating hypertensive patients to become familiar with sexual dysfunction (through better education and specific seminars) for the proper management of these patients.
This paper references
Double-blind, parallel, comparative study on quality of life during treatment with amlodipine or enalapril in mild or moderate hypertensive patients: a multicentre study
Per Omvik (1993)
Metabolic outcome during 1 year in newly detected hypertensives: results of the Antihypertensive Treatment and Lipid Profile in a North of Sweden Efficacy Evaluation (ALPINE study)
Lars Lindholm (2003)
Cyclic nucleotide phosphodiesterase (PDE) superfamily: a new target for the development of specific therapeutic agents.
Claire Lugnier (2006)
Erectile dysfunction and subsequent cardiovascular disease.
Ian M Thompson (2005)
The multinational Men's Attitudes to Life Events and Sexuality (MALES) study: I. Prevalence oSf erectile dysfunction and related health concerns in the general population
Raymond C. Rosen (2004)
Side-effects of antihypertensive treatment: a placebo-controlled study.
Gaston E. Bauer (1978)
The high prevalence of sexual concerns among women seeking routine gynecological care.
Margaret R. H. Nusbaum (2000)
Impact of antihypertensive therapy on quality of life: effect of hydrochlorothiazide.
Gordon H. Williams (1987)
Quality of life assessment in sexual dysfunction trials.
Raymond C. Rosen (1998)
Glu298Asp endothelial nitric oxide synthase polymorphism is a risk factor for erectile dysfunction in the Mexican Mestizo population.
Haydeé Rosas-Vargas (2004)
Prevalence and correlates of erectile dysfunction in Turkey: a populationbased study
E Akkus (2002)
Erectile dysfunction: an early marker for hypertension? A longitudinal study in spontaneously hypertensive rats.
Delphine Behr-Roussel (2005)
Effects of first-line
H Suzuki (1993)
Effect of Frequently Prescribed Cardiovascular Medications on Sexual Function: A Pilot Study
B A Kroner (1993)
Erectile dysfunction in spontaneously hypertensive rats: pathophysiological mechanisms.
Delphine Behr-Roussel (2003)
Endothelin and erectile dysfunction: a target for pharmacological intervention?
Mohammad A Khan (1998)
Sexual Activity and Function in Postmenopausal Women With Heart Disease
Ilana B. Addis (2005)
Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors
E D Laumann (2005)
Cyclic nucleotide phosphodiesterases: functional implications
JA Beavo (1998)
The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine.
Graham Jackson (2006)
Sexual dysfunction in primary medical care: prevalence, characteristics and detection by the general practitioner.
Stephen Read (1997)
R. Dusing (2003)
Cardiovascular effects of tadalafil.
Robert A. Kloner (2003)
Sildenafil citrate and blood-pressure-lowering drugs: results of drug interaction studies with an organic nitrate and a calcium antagonist.
David J. Webb (1999)
Endothelin as a putative modulation of erectile physiology and dysfunction. I. Characteristics of ET1-induced contractions in isolated corporal smooth muscle strips
GJ Christ (1995)
Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study.
Catherine B. Johannes (2000)
After sildenafil: bridging the gap between pharmacologic treatment and satisfying sexual relationships.
Sandra Risa Leiblum (2002)
The penis is not protected — in hypertension there are vascular changes in the penis which are similar to those in other vascular beds
Hiromi Okabe (1999)
Does severity of ischaemic coronary disease correlate with erectile function?
M.E. Sullivan (1998)
Erectile dysfunction is a marker for cardiovascular complications and psychological functioning in men with hypertension
Martin Burchardt (2001)
Report of the international consensus development conference on female sexual dysfunction: definitions and classifications.
R Basson (2000)
Prevalence and risk factors for erectile dysfunction in 2869 men using a validated questionnaire.
Anton Ponholzer (2005)
Sexual dysfunction in the United States: prevalence and predictors.
Edward O. Laumann (1999)
Endothelin-1-induced alterations in phenylephrine-induced contractile responses are largely additive in physiologically diverse rabbit vasculature.
M C Gondré (1998)
The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease.
Piero Montorsi (2005)
IS IMPOTENCE AN ARTERIAL DISORDER?: A Study of Arterial Risk Factors in 440 Impotent Men
Ronald Virag (1985)
Ejaculatory abnormalities in mice with targeted disruption of the gene for heme oxygenase-2
Arthur L. Burnett (1998)
Sexual function in hypertensive males treated with lisinopril or atenolol: a cross-over study.
Roberto Fogari (1998)
Change in symptoms of hypertensive patients after referral to hospital clinic.
Christopher John Bulpitt (1976)
Effect of sildenafil in patients with erectile dysfunction taking antihypertensive therapy. Sildenafil Study Group.
Robert A. Kloner (2001)
Tissue angiotensin II as a modulator of erectile function. I. Angiotensin peptide content, secretion and effects in the corpus cavernosum.
Imre Kifor (1997)
The Prevalence of Sexual Dysfunction in Male and Female Hypertensive Patients
Alan J. Riley (1987)
Effects of sildenafil citrate on human hemodynamics.
Graham Jackson (1999)
Sexual dysfunction in essential hypertension: myth or reality?
Michael Doumas (2006)
Erectile dysfunction in essential arterial hypertension and effects of sildenafil: results of a Spanish national study.
Pedro Moreno Aranda (2004)
Left ventricular diastolic function and endothelial function in patients with erectile dysfunction.
Nevzat Uslu (2006)
The prevalence and etiology of impotence in 101 male hypertensive outpatients.
Jakob Willas Jensen (1999)
Oxidised low-density lipoproteins inhibit relaxations of porcine coronary arteries: role of scavenger receptor and endothelium-derived nitric oxide
FC Tanner (1991)
men with erectile dysfunction
M Doumas (2003)
Sildenafil Study Group. Effect of sildenafil in patients with erectile dysfunction taking antihypertensive therapy
RA Kloner (2001)
Sexual Dysfunction in Hypertensive Patients Treated with Losartan
José Luis Llisterri Caro (2001)
Product monograph for Levitra (vardenafil HCL). Bayer Healthcare, Glaxo SmithKline
Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study.
Charalambos Vlachopoulos (2005)
Subclinical coronary artery atherosclerosis in patients with erectile dysfunction.
Emilio Chiurlia (2005)
Long - term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women : Treatment of Mild
RH Grimm (2004)
Global burden of hypertension: analysis of worldwide data
Patricia M. Kearney (2005)
Safety and efficacy of vardenafil, a selective phosphodiesterase 5 inhibitor, in patients with erectile dysfunction and arterial hypertension treated with multiple antihypertensives.
Hermann van Ahlen (2005)
Effect of sildenafil citrate on blood pressure and heart rate in men with erectile dysfunction taking concomitant antihypertensive medication
Randall M. Zusman (2000)
Sexual function problems and help seeking behaviour in Britain: national probability sample survey
Catherine H Mercer (2003)
NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence.
Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS)
Richard H. Grimm (1997)
Cigarette smoking and other vascular risk factors in vasculogenic impotence.
Ridwan Shabsigh (1991)
Possible role of bradykinin and angiotensin II in the regulation of penile erection and detumescence.
Armin J. Becker (2001)
The Social Organization of Sexuality: Sexual Practices in the United States
Virginia A. Sadock (1995)
Chapter 1: The management of erectile dysfunction: an AUA update.
Drogo K. Montague (2005)
ACE gene ID and NOS 3 F 894 T polymorphisms and response to sildenafil in men with erectile dysfunction
A Eisenhardt (2003)
Effects of first‐line antihypertensive agents on sexual function and sex hormones
Hiroshi Suzuki (1988)
Factors affecting the increased prevalence of erectile dysfunction in hypertensive compared to normotensive individuals
M Doumas (2005)
Sexual Function in Men Older Than 50 Years of Age: Results from the Health Professionals Follow-up Study
Constance G Bacon (2003)
Sexual activity in hypertensive men treated with valsartan or carvedilol: a crossover study.
Roberto Fogari (2001)
Does hypertension and its pharmacotherapy affect the quality of sexual function in women?
L E Duncan (2000)
Effect of the angiotensin II antagonist valsartan on sexual function in hypertensive men
Rainer Duesing (2003)
Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study.
Antonio Martín‐Morales (2001)
Phosphodiesterase V inhibitors
KJ Murray (2008)
Effect of angiotensin II on corpus cavernosum smooth muscle in relation to nitric oxide environment: in vitro studies in canines
CV Comiter (1997)
Erectile dysfunction in diabetes and hypertension.
Herbert F. Newman (1985)
Nitric oxide and cyclic GMP formation upon electrical field stimulation cause relaxation of corpus cavernosum smooth muscle.
Louis Joseph Ignarro (1990)
The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences.
I A Ayta (1999)
Effect of antihypertensives on sexual function and quality of life: the TAIM Study.
Sylvia Wassertheil-Smoller (1991)
Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease.
Charalambos Vlachopoulos (2006)
Cyclic nucleotide phosphodiesterases: functional implications of multiple isoforms.
Joseph A. Beavo (1995)
Effects of sildenafil on the relaxation of human corpus cavernosum tissue in vitro and on the activities of cyclic nucleotide phosphodiesterase isozymes.
Stephen A. Ballard (1998)
Sex hormones and hemostatic risk factors for coronary heart disease in men with hypertension
Gerald B. Phillips (1993)
Impaired coronary blood flow response to acetylcholine in patients with coronary risk factors and proximal atherosclerotic lesions.
Kensuke Egashira (1993)
The effect of antihypertensive drugs on erectile function: a proposed management algorithm.
Michael Doumas (2006)
Protection of cavernous tissue in male spontaneously hypertensive rats. Beyond blood pressure control.
J E Toblli (2004)
Brief sexual inquiry in gynecologic practice.
Gloria A. Bachmann (1989)
Pharmacological characterization of kinin-induced relaxation of human corpus cavernosum.
Saravanan Namasivayam (1998)
Effect of antihypertensive treatment with valsartan or atenolol on sexual activity and plasma testosterone in hypertensive men
Roberto Fogari (2002)
Sexual symptoms in hypertensive patients. A clinical trial of antihypertensive medications.
Sydney H. Croog (1988)
Inflammation, metabolic syndrome, erectile dysfunction, and coronary artery disease: common links.
Charalambos Vlachopoulos (2007)
Prevalence and correlates of erectile dysfunction in a population-based study in Belgium.
Rudolf P Mak (2002)
for the Sildenafil Study Group. Effect of sildenafil in patients with erectile dysfunction taking antihypertensive therapy
R A Kloner (2001)
Effects of age, comorbidity and lifestyle factors on erectile function: Tampere Ageing Male Urological Study (TAMUS).
Rahman Shiri (2004)
Determinants of erectile dysfunction risk in a large series of Italian men attending andrology clinics.
Vincenzo G Mirone (2004)
Chronic administration of an oral Rho kinase inhibitor prevents the development of vasculogenic erectile dysfunction in a rat model.
Kwanjin Park (2006)
Determination of Human Angiotensin Converting Enzyme (ACE) Gene Polymorphisms in Erectile Dysfunction: Frequency Differences of ACE Gene Polymorphisms according to the Method of Analysis
Deokyu Kim (2001)
Sexual activity in hypertensive men
Andrea Della Chiesa (2003)
Recovery of erectile function after brief aggressive antihypertensive therapy.
Taben M. Hale (2002)
Time course of the interaction between tadalafil and nitrates.
Robert A. Kloner (2003)
Antihypertensive drugs induce structural remodeling of the penile vasculature.
Taben M. Hale (2001)
B - blocker therapy and symptoms of depression , fatigue , and sexual dysfunction
R Fogari (2002)
Age-related prevalence of erectile dysfunction in Japan: assessment by the International Index of Erectile Function.
Ken Marumo (2001)
Report of erectile dysfunction after therapy with beta-blockers is related to patient knowledge of side effects and is reversed by placebo.
Antonello Silvestri (2003)
On life satisfaction in male erectile dysfunction
Ar Fugl-Meyer (1997)
Relationship Between Erectile Dysfunction and Silent Myocardial Ischemia in Apparently Uncomplicated Type 2 Diabetic Patients
Carmine Gazzaruso (2004)
Sexual dysfunction and cardiac risk (the Second Princeton Consensus Conference).
John B. Kostis (2005)
Impact of erectile dysfunction on quality of life: patient and partner perspectives
Gorm Wagner (2000)
Use of sildenafil (Viagra) in patients with cardiovascular disease. American College of Cardiology/American Heart Association
M D Cheitlin (1999)
Dyslipidemia as a risk factor for erectile dysfunction.
George E. Vrentzos (2007)
Relation of erectile dysfunction to angiographic coronary artery disease.
Hemant Solomon (2003)
Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease.
Francesco Montorsi (2003)
2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension.
Giuseppe Mancia (2007)
Beneficial effect of b - blockers switch to nebivolol on erectile function in hypertensive patients
A Silvestri (2006)
Epidemiology of erectile dysfunction: results of the ‘Cologne Male Survey’
Martin Braun (2000)
Lack of effect of carbon monoxide inhibitor on relaxation induced by electrical field stimulation in corpus cavernosum
Yong Chul Kim (1994)
Erectile dysfunction and sildenafil citrate and cardiologists.
Robert A. Kloner (1999)
Hypertension and the vasculature: arterioles and the myogenic response
Ashley S. Izzard (1995)
Increased incidence of depressive symptoms in men with erectile dysfunction.
Ridwan Shabsigh (1998)
The making of a disease: female sexual dysfunction.
Allen D. Seftel (2003)
Efficacy of tadalafil in the treatment of erectile dysfunction in hypertensive men on concomitant thiazide diuretic therapy
Robert A. Kloner (2005)
Adverse reactions to bendrofluazide andpropranolol for the treatment of mild hypertension
Endothelin: localization, synthesis, activity, and receptor types in human penile corpus cavernosum.
Iñigo Sáenz de Tejada (1991)
ACC/AHA expert consensus document. Use of sildenafil (Viagra) in patients with cardiovascular disease. American College of Cardiology/American Heart Association.
Melvin D. Cheitlin (1999)
Epidemiology of erectile dysfunction in four countries: cross-national study of the prevalence and correlates of erectile dysfunction.
Alfredo Nicolosi (2003)
Phosphodiesterase type 5 as a pharmacologic target in erectile dysfunction.
Jackie D. Corbin (2002)
The epidemiology of erectile dysfunction and its risk factors.
Angela Bortolotti (1997)
Renin angiotensin system in rabbit corpus cavernosum: functional characterization of angiotensin II receptors.
J K Park (1997)
Sexual activity and plasma testosterone levels in hypertensive males.
Roberto Fogari (2002)
Cardiovascular effects of tadalafil in patients on common antihypertensive therapies.
Robert A. Kloner (2003)
Health-related quality of life in men with erectile dysfunction
Mark S. Litwin (2007)
Female sexual dysfunction in essential hypertension: a common problem being uncovered
Michael Doumas (2006)
Sildenafil citrate for erectile dysfunction in men receiving multiple antihypertensive agents: a randomized controlled trial.
Thomas G. Pickering (2004)
Erectile dysfunction in hypertensive subjects. Assessment of potential determinants.
Anat Jaffe (1996)
Erectile dysfunction in the cardiac patient: how common and should we treat?
Robert A. Kloner (2003)
Vasculogenic erectile dysfunction: beyond the haemodynamic changes.
Kazem M. Azadzoi (2006)
Erectile dysfunction in hypertensive rats results from impairment of the relaxation evoked by neurogenic carbon monoxide and nitric oxide.
Masayuki Ushiyama (2004)
[The effects of antihypertensive therapy on the quality of life].
W de Oliveira Júnior (1989)
Serum sex hormones in patients with coronary disease and their relationship to known factors causing atherosclerosis.
B Labropoulos (1982)
Morphologic changes in cavernous tissue in spontaneously hypertensive rats
JE Toblli (2000)
Efficacy and safety of vardenafil, a selective phosphodiesterase 5 inhibitor, in men with erectile dysfunction on antihypertensive therapy
Hartmut Porst (2002)
Quality of life and erectile dysfunction.
Stanley E. Althof (2002)
Study ( TOMHS )
R Virag (1997)
Multiple pathways of angiotensin I conversion and their functional role in the canine penile corpus cavernosum.
Yusaku Iwamoto (2001)
The effect of erectile dysfunction on quality of life: psychometric testing of a new quality of life measure for patients with erectile dysfunction.
Ruaraidh P. MacDonagh (2002)
Overview of the cardiovascular effects of tadalafil
Jeffrey T. Emmick (2002)
Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study.
Henry A. Feldman (1994)
Erectile dysfunction: from biochemical pharmacology to advances in medical therapy.
Mario Maggi (2000)
Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction.
Mitra Boolell (1996)
Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study.
Henry A. Feldman (2000)
TREATMENT OF MILD HYPERTENSION
Risteárd Mulcahy (1983)
This paper is referenced by
Erectile Dysfunction: AUA Guideline
Arthur L. Burnett (2018)
The erectile dysfunction as a cardiovascular risk factor
Nathan Artom (2014)
Effects of antihypertensive therapy on female sexual dysfunction: clinically meaningful?
Michael Doumas (2012)
A Modern Understanding of the Traditional and Nontraditional Biological Functions of Angiotensin-Converting Enzyme
K. E. Bernstein (2013)
Physical Activity, Fitness, and Sexual Dysfunction
Konstantinos P Imprialos (2019)
Erectile dysfunction in obstructive sleep apnea syndrome—Prevalence and determinants
T. Santos (2012)
Nadciśnienie tętnicze a zaburzenia funkcji seksualnych Hypertension and sexual dysfunction
Athanasios J. Manolis (2007)
Local estrogens for quality of life and sexuality in postmenopausal women with cardiovascular disease
Rossella Elena Nappi (2009)
Blood Pressure, Sexual Activity, and Erectile Function in Hypertensive Men: Baseline Findings from the Systolic Blood Pressure Intervention Trial (SPRINT).
Capri Foy (2019)
Sexual Dysfunction among Patients with Diabetes Mellitus
Fred R Owiti (2012)
Antihypertensive Drugs and Male Sexual Dysfunction
Khalid Ahmed Jassim Al Khaja (2016)
The Erectile Dysfunction among Congolese Hypertensive Patients
Stéphane Méo Ikama (2018)
Validação do Índice Internacional de Função Erétil (IIFE) para Uso
Ana Inês Gonzáles (2013)
Resumen de la Guía de Práctica Clínica de Disfunción Eréctil – Sociedad Colombiana de Urología
María del Pilar Ceballos (2018)
The effect of antihypertensive therapy on human sexuality
Bohdana Břegová (2015)
Phosphodiesterase type 5 (PDE5) inhibitors in erectile dysfunction: the proper drug for the proper patient.
Giovanni Corona (2011)
Does vitamin D deficiency contribute to erectile dysfunction?
Marc B Sorenson (2012)
Hypertension and sexual dysfunction
James A. Ker (2012)
Determining the Prognostic Implications of Erectile Dysfunction for Future Cardiovascular Disease with Noninvasive Testing
Charalambos Vlachopoulos (2014)
2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).
Giuseppe Mancia (2013)
Combined Antihypertensive Therapy and Sexual Dysfunction: Terra Incognita
Michael Doumas (2013)
Método de selección de tratamiento antihipertensivo Method of selection of antihypertensive treatment
José Elías González Ybarzábal (2013)
Let’s talk about sex
Cornelia Adriana de Vries Feyens (2013)
Prevalencia de comorbilidades y factores de riesgo asociados a disfuncion erectil en pacientes hipertensos del Hospital Universitario del Caribe de Cartagena en 2013
Juan Fernando Uribe Arcila (2014)
Treatment with nitrite prevents reactive oxygen species generation in the corpora cavernosa and restores intracavernosal pressure in hypertensive rats.
Natália A. Gonzaga (2019)
Sexual activity and function among middle-aged and older men and women with hypertension
Erica S Spatz (2013)
Disfunção erétil na síndrome de apneia obstrutiva do sono – Prevalência e determinantes
T. Santos (2012)
Sex and Hypertension
Ak Pancholia (2013)
2007 ESH‐ESC Guidelines for the management of arterial hypertension
Giuseppe Mansia (2007)
Golombok Rust Inventory of Sexual Satisfaction for the presence of sexual dysfunction within a Ghanaian urological population
Nafiu Amidu (2014)
Sexual Dysfunction in Female Cancer Survivors
Michael Desimone (2014)
Sexual Counseling for Patients with Cardiovascular Disease
Athanasios Manolis (2015)See more