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Evaluation and Management of Erectile Dysfunction in the Hypertensive Patient

Jay Pravin Patel1,2, Eric Hweegeun Lee1,2, Carlos Ignacio Mena-Hurtado3

  • 1Yale School of Medicine, PO Box 208058, New Haven, CT, 06520-8058, USA.

Current Cardiology Reports
|August 25, 2017
PubMed

Insights

Hypertension and erectile dysfunction often coexist. For hypertensive men with erectile dysfunction, consider angiotensin-receptor blockers, ACE inhibitors, or calcium channel blockers, with PDE-5 inhibitors as a first-line treatment.

Area of Science:

  • Cardiovascular Medicine
  • Urology
  • Pharmacology

Background:

  • Hypertension and erectile dysfunction (ED) prevalence are rising, with over 40% of men with ED also diagnosed with hypertension.
  • Managing patients with both conditions presents a clinical challenge due to their correlation and shared risk factors.
  • A knowledge gap exists among clinicians regarding the diagnosis and treatment of ED in hypertensive patients.

Purpose of the Study:

  • To review current literature on diagnosing and treating ED in hypertensive patients.
  • To provide clinical recommendations for managing this patient population.
  • To address the complexities of co-occurring hypertension and ED.

Main Methods:

  • Literature review of current research on hypertension and erectile dysfunction.
  • Analysis of pharmacological treatments for hypertension and their impact on sexual function.
  • Evaluation of treatment guidelines for erectile dysfunction in hypertensive individuals.

Main Results:

  • Antihypertensive medications can negatively impact sexual function; some ED treatments are contraindicated with specific antihypertensives.
  • Recommended hypertension treatments for men with ED include angiotensin-receptor blockers, followed by angiotensin-converting enzyme inhibitors or calcium channel blockers.
  • Phosphodiesterase type 5 (PDE-5) inhibitors are the first-line treatment for ED, but cardiovascular fitness for sexual activity must be assessed.

Conclusions:

  • Careful selection of antihypertensive agents is crucial to avoid adverse effects on sexual function.
  • Angiotensin-receptor blockers, ACE inhibitors, and calcium channel blockers are preferred for hypertension in men with ED.
  • PDE-5 inhibitors are effective for ED, necessitating a prior cardiovascular assessment.
Abstract

Keywords:
Erectile dysfunctionHypertension

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