Comparative effects of prazosin and hydrochlorothiazide on sexual function in hypertensive men

Evidence suggests that there may be differences in the incidence of drug-induced sexual dysfunction among the antihypertensive agents. This study assessed objective and subjective aspects of sexual dysfunction in hypertensive male patients in relation to two antihypertensive agents--prazosin and hydrochlorothiazide. A total of 12 hypertensive patients were evaluated in a crossover study utilizing a sleep laboratory to obtain polysomnographic evaluations of sleep patterns along with changes in nocturnal penile tumescence and buckling pressure. Objectively, no significant changes were observed between the two antihypertensive agents in relation to rapid eye movement-related sleep architecture, serum testosterone levels, or penile blood flow. Decrements in buckling pressure and subjective aspects of sexual dysfunction were greater during hydrochlorothiazide treatment than during prazosin treatment. Both drugs were effective in controlling blood pressure.