A Review of the Positive and Negative Effects of Cardiovascular Drugs on Sexual Function: a Proposed Table for Use in Clinical Practice

Overview

Journal Neth Heart J

Specialty Cardiology & Vascular Diseases

Date 2013 Oct 25

PMID 24155101

Citations 22

Authors

M P J Nicolai

S S Liem

S Both

R C M Pelger

H Putter

M J Schalij

H W Elzevier

Affiliations

Soon will be listed here.

Abstract

Several antihypertensive drugs, such as diuretics and β-blockers, can negatively affect sexual function, leading to diminished quality of life and often to noncompliance with the therapy. Other drug classes, however, such as angiotensin II receptor blockers (ARBs) are able to improve patients' sexual function. Sufficient knowledge about the effects of these widely used antihypertensive drugs will make it possible for cardiologists and general practitioners to spare and even improve patients' sexual health by switching to different classes of cardiac medication. Nevertheless, previous data (part I) indicate that most cardiologists lack knowledge about the effects cardiovascular agents can have on sexual function and will thus not be able to provide the necessary holistic patient care with regard to prescribing these drugs. To be able to improve healthcare on this point, we aimed to provide a practical overview, for use by cardiologists as well as other healthcare professionals, dealing with sexual dysfunction in their clinical practices. Therefore, a systematic review of the literature was performed. The eight most widely used classes of antihypertensive drugs have been categorised in a clear table, marking whether they have a positive, negative or no effect on sexual function.

Citing Articles

Common Determinants of Blood Pressure and Testosterone LevelReply.

Sener Y, Ceasovschih A Arq Bras Cardiol. 2024; 121(7):e20240234.

PMID: 39194000 PMC: 11495812. DOI: 10.36660/abc.20240234.

Prevalence of Cardiovascular Drugs and Oral Anticoagulant Use among Persons with and without Parkinson's Disease.

Babar B, Kettunen R, Tiihonen M, Hartikainen S, Tolppanen A Cardiology. 2023; 149(2):127-136.

PMID: 38071963 PMC: 10994629. DOI: 10.1159/000535691.

Heart Failure and Erectile Dysfunction: a Review of the Current Evidence and Clinical Implications.

Carella M, Forleo C, Stanca A, Carulli E, Basile P, Carbonara U Curr Heart Fail Rep. 2023; 20(6):530-541.

PMID: 37962749 PMC: 10746762. DOI: 10.1007/s11897-023-00632-y.

Genetically predicted hypertension, antihypertensive drugs, and risk of erectile dysfunction: a Mendelian randomization study.

Zhao C, Feng J, Deng S, Wang X, Fu Y, Wang B Front Cardiovasc Med. 2023; 10:1157467.

PMID: 37363097 PMC: 10289031. DOI: 10.3389/fcvm.2023.1157467.

Patient reporting of sexual adverse events on an online platform for medication experiences.

Gordijn R, Wessels W, Kriek E, Nicolai M, Elzevier H, Visser L Br J Clin Pharmacol. 2022; 88(12):5326-5335.

PMID: 35778921 PMC: 9796902. DOI: 10.1111/bcp.15454.

References

Kley H, ABENDROTH H, Hehrmann R, Muller A, Keck E, Schneitler H . [No effect of digitalis on sex and adrenal hormones in healthy subjects and in patients with congestive heart failure]. Klin Wochenschr. 1984; 62(2):65-73. DOI: 10.1007/BF01769665. View

Rastogi S, Rodriguez J, Kapur V, Schwarz E . Why do patients with heart failure suffer from erectile dysfunction? A critical review and suggestions on how to approach this problem. Int J Impot Res. 2006; 17 Suppl 1:S25-36. DOI: 10.1038/sj.ijir.3901426. View

Cheng J . Nebivolol: a third-generation beta-blocker for hypertension. Clin Ther. 2009; 31(3):447-62. DOI: 10.1016/j.clinthera.2009.03.007. View

Castro M, Rizzi E, Rascado R, Nagassaki S, Bendhack L, Tanus-Santos J . Atorvastatin enhances sildenafil-induced vasodilation through nitric oxide-mediated mechanisms. Eur J Pharmacol. 2004; 498(1-3):189-94. DOI: 10.1016/j.ejphar.2004.07.051. View

Gupta S, Salimpour P, Saenz de Tejada I, Daley J, Gholami S, Daller M . A possible mechanism for alteration of human erectile function by digoxin: inhibition of corpus cavernosum sodium/potassium adenosine triphosphatase activity. J Urol. 1998; 159(5):1529-36. DOI: 10.1097/00005392-199805000-00033. View

Grosser N, Hemmerle A, Berndt G, Erdmann K, Hinkelmann U, Schurger S . The antioxidant defense protein heme oxygenase 1 is a novel target for statins in endothelial cells. Free Radic Biol Med. 2004; 37(12):2064-71. DOI: 10.1016/j.freeradbiomed.2004.09.009. View

Kostis J, Jackson G, Rosen R, Barrett-Connor E, Billups K, Burnett A . Sexual dysfunction and cardiac risk (the Second Princeton Consensus Conference). Am J Cardiol. 2005; 96(2):313-21. DOI: 10.1016/j.amjcard.2005.03.065. View

Silvestri A, Galetta P, Cerquetani E, Marazzi G, Patrizi R, Fini M . Report of erectile dysfunction after therapy with beta-blockers is related to patient knowledge of side effects and is reversed by placebo. Eur Heart J. 2003; 24(21):1928-32. DOI: 10.1016/j.ehj.2003.08.016. View

Perez-Stable E, Halliday R, Gardiner P, Baron R, Hauck W, Acree M . The effects of propranolol on cognitive function and quality of life: a randomized trial among patients with diastolic hypertension. Am J Med. 2000; 108(5):359-65. DOI: 10.1016/s0002-9343(00)00304-1. View

10.

Fogari R, Zoppi A, Poletti L, Marasi G, Mugellini A, Corradi L . Sexual activity in hypertensive men treated with valsartan or carvedilol: a crossover study. Am J Hypertens. 2001; 14(1):27-31. DOI: 10.1016/s0895-7061(00)01214-0. View

11.

Baumhakel M, Custodis F, Schlimmer N, Laufs U, Bohm M . Improvement of endothelial function of the corpus cavernosum in apolipoprotein E knockout mice treated with irbesartan. J Pharmacol Exp Ther. 2008; 327(3):692-8. DOI: 10.1124/jpet.108.140533. View

12.

Doumas M, Tsakiris A, Douma S, Grigorakis A, Papadopoulos A, Hounta A . Beneficial effects of switching from beta-blockers to nebivolol on the erectile function of hypertensive patients. Asian J Androl. 2006; 8(2):177-82. DOI: 10.1111/j.1745-7262.2006.00076.x. View

13.

Dadkhah F, Safarinejad M, Asgari M, Hosseini S, Lashay A, Amini E . Atorvastatin improves the response to sildenafil in hypercholesterolemic men with erectile dysfunction not initially responsive to sildenafil. Int J Impot Res. 2009; 22(1):51-60. DOI: 10.1038/ijir.2009.48. View

14.

Segal R, Bivalacqua T, Burnett A . Irbesartan promotes erection recovery after nerve-sparing radical retropubic prostatectomy: a retrospective long-term analysis. BJU Int. 2012; 110(11):1782-6. DOI: 10.1111/j.1464-410X.2012.11098.x. View

15.

Solomon H, Samarasinghe Y, Feher M, Man J, Rivas-Toro H, Lumb P . Erectile dysfunction and statin treatment in high cardiovascular risk patients. Int J Clin Pract. 2006; 60(2):141-5. DOI: 10.1111/j.1742-1241.2006.00793.x. View

16.

Kochar M, Mazur L, Patel A . What is causing your patient's sexual dysfunction? Uncovering a connection with hypertension and antihypertensive therapy. Postgrad Med. 1999; 106(2):149-52, 155-7. DOI: 10.3810/pgm.1999.08.655. View

17.

Becker A, Uckert S, Stief C, Truss M, Machtens S, Scheller F . Possible role of bradykinin and angiotensin II in the regulation of penile erection and detumescence. Urology. 2001; 57(1):193-8. DOI: 10.1016/s0090-4295(00)00881-5. View

18.

. AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol. 2003; 170(2 Pt 1):530-47. DOI: 10.1097/01.ju.0000078083.38675.79. View

19.

Duncan L, Bateman D . Sexual function in women. Do antihypertensive drugs have an impact?. Drug Saf. 1993; 8(3):225-34. DOI: 10.2165/00002018-199308030-00004. View

20.

Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B . Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003; 348(14):1309-21. DOI: 10.1056/NEJMoa030207. View