Sexual dysfunction in hypertensive patients treated with losartan

Impaired erectile function in men is a component of the dysmetabolic syndrome of high blood pressure as well as a sequela of antihypertensive therapy. This prospective interventional study in men with uncontrolled hypertension (blood pressure > or =140/90 mm Hg) used a survey instrument to assay sexual dysfunction before and after therapy with losartan.

We evaluated the influence of a 12-week therapy with losartan in 82 hypertensive subjects with (n = 82) and without (n = 82) a diagnosis of erectile dysfunction using a self-administered questionnaire validated in another 60 subjects with hypertension.

From an initial sample of 323 hypertensive men and women, 82 men, aged 30 to 65 years, with sexual dysfunction underwent a 12-week regimen of losartan therapy (50-100 mg/day). Losartan treatment improved sexual satisfaction from an initial 7.3 to 58.5% (chi2; P = 0.001). Subjects reporting a high frequency of sexual activity improved from 40.5% initially to 62.3% after drug treatment, whereas the number of patients with low or very low frequency of sexual activity decreased significantly (chi2; P = 0.001). At the completion of the 12-week losartan regimen, only 11.8% of the treated subjects reported in improvement in sexual function. Improvement on quality of life was demonstrated in 73.7% of subjects medicated with losartan, 25.5% reported no changes, and only 0.8% felt worse. In the group without sexual dysfunction, losartan had a nonsignificant effect on sexual function.

Our data suggest that losartan improved erectile function and both satisfaction and frequency of sexual activity. Because side effects are one of the most influential factors in the management of hypertension, an added benefit of losartan therapy may be its positive impact on quality of life.