‘Choose hypertension medication carefully to protect male sexual function’

Medical practitioners have been told to consider choosing antihypertensive medicines with the lowest possible potential for adverse drug effects such as sexual dysfunctions among adult hypertensive men in order to attain an optimum balance between antihypertensive efficacy and adequate preservation of sexual functions.

This is following the finding that calcium channel blockers (CCBs), the most frequent antihypertensive drugs prescribed for hypertensive adult male medical patients were associated with the highest occurrence of sexual dysfunctions, followed by diuretics, ACE inhibitors and centrally acting antihypertensives.

The researchers, in a prospective study of the effect of antihypertensive medications on the sexual functions of hypertensive adult male patients at the medical outpatient clinic of LUTH, Lagos state Nigeria, had observed that majority of the respondents who experienced sexual dysfunctions were on a CCB-containing antihypertensive medication combinations.

According to them, paying attention to the symptomatic wellbeing, activity and sexual functions, all essential part of good quality of life of hypertensive adult male patients was important to increase adherence to treatment.

The study, in 2020 Future Science OA, an online, open access, peer-reviewed title, involved Akinwumi Akinyinka Akinyede; Obiyo Nwaiwu; Adedunni Olusanya; Sunday Olufemi Olayemi and Bisola Akande at the University of Lagos in collaboration with Olumuyiwa John Fasipe at the University of Medical Sciences, Ondo.

The study recruited 159 hypertensive men aged 30 to 98 years being managed at the hospital between January 2017 and April 2017. The highest occurrence of sexual dysfunctions was associated with calcium-channel blockers in 32 (20.1 per cent) patients, followed by diuretics in 27 (17.0 per cent) and, angiotensin-converting enzyme inhibitors (ACE inhibitors) in 20 (12.6 per cent) patients.

The researchers found mild-to-moderate erectile dysfunction in 62 (39.0 per cent) patients, followed by mild erectile dysfunction in 58 (36.5 per cent) patients, severe erectile dysfunction in 10 (6.3 per cent) patients, moderate erectile dysfunction in 9 (5.7 per cent) patients, while 20 (12.6 per cent) patients had an adequate erectile function.

There was mild intercourse dissatisfaction in 56 (35.2 per cent) patients, followed by mild-to-moderate intercourse dissatisfaction in 47 (29.6per cent) patients, moderate intercourse dissatisfaction in 24 (15.1per cent) patients, severe intercourse dissatisfaction in 19 (11.9 per cent) patients, while 13 (8.2per cent) patients had adequate intercourse satisfaction.

In addition, there was mild orgasmic dysfunction in 56 (35.2 per cent) patients, followed by moderate orgasmic dysfunction in 34 (21.4 per cent) patients, mild-to-moderate orgasmic dysfunction in 30 (18.9 cent) patients, severe orgasmic dysfunction in 13 (8.2per cent) patients, while 26 (16.4 per cent) patients had an adequate orgasmic function.

Given that no class of antihypertensive medications clearly produces superior effects over the others in terms of preservation of sexual functions, they said for all persons with hypertension, the potential benefits of a healthy diet, weight control and regular exercise cannot be overemphasised in improving blood pressure control, reducing medication needs as well as in reducing adverse effects of hypertension drug.

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