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Erectile dysfunction and antihypertensive therapy: A critical reappraisal
Athanasios J Manolis1, Manolis S Kallistratos1, Maria Koutsaki1
1Cardiology Department METROPOLITAN Hospital, Piraeus, Greece.
European Journal of Internal Medicine
|April 10, 2026
Summary
Erectile dysfunction (ED) and arterial hypertension share vascular causes. Newer antihypertensive drugs offer neutral or beneficial effects on erectile function, unlike older medications.
Area of Science:
- Cardiovascular Medicine
- Urology
- Pharmacology
Background:
- Erectile dysfunction (ED) frequently co-occurs with arterial hypertension.
- Both conditions share underlying vascular pathophysiology.
- Antihypertensive treatments can impact sexual function.
Purpose of the Study:
- To critically review the relationship between different classes of antihypertensive drugs and ED.
- To discuss the mechanisms underlying these interactions.
- To provide evidence-based recommendations for clinical practice.
Main Methods:
- Scrutinized review of recent scientific evidence.
- Analysis of pharmacological effects on erectile function.
- Synthesis of data for clinical recommendations.
Main Results:
- Older antihypertensive drugs significantly impacted erectile function.
- Newer antihypertensive agents demonstrate neutral or beneficial effects on ED.
- The relationship between antihypertensives and ED is complex and nuanced.
Conclusions:
- Antihypertensive medication choice requires careful consideration of potential effects on erectile function.
- Evidence supports a shift towards newer agents with improved sexual side-effect profiles.
- Clinical practice should integrate these findings for optimized patient care.
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