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Sexual activity and function among middle-aged and older men and women with hypertension

Spatz, Erica S.a; Canavan, Maureen E.b; Desai, Mayur M.c; Krumholz, Harlan M.d,e; Lindau, Stacy T.f,g

doi: 10.1097/HJH.0b013e32835fdefa

Objective: To determine the association of hypertension (HTN) and its treatment with sexual function in middle-aged and older adults.

Methods: We studied a nationally representative sample of community-residing adults aged 57–85 years (n = 3005) from the National Social Health, Life and Aging Project. Adults were categorized by HTN status (treated, untreated, and no HTN). Antihypertensive medication use was classified into calcium channel blocker; β-blocker; angiotensin-converting enzyme inhibitor/angiotensin receptor blocker; diuretic; and α-blocker. For each HTN and medication group, we determined the prevalence and adjusted odds of being sexually active and of having any sexual problem.

Results: Among men, comparing treated HTN with untreated HTN and no HTN, sexual activity was less prevalent (66.5 vs. 75.9 vs.71.5%, P <0.01) and sexual problems were more prevalent (69.1 vs. 57.7 vs. 54.3%; P ≤ 0.01). There was no association between treated HTN and sexual activity [odds ratio, OR = 0.86 (95% confidence interval 0.51–1.45)] and a nonsignificant association between treated HTN and sexual problems [OR = 1.49 (0.94–2.37)]. Among women, the prevalence of sexual activity was lower in the treated and untreated HTN groups than the no HTN group (35.2 vs. 38.3 vs. 58.0%, P <0.01); the prevalence of sexual problems was similar (73.7 vs. 65.3 vs. 71.7%; P = 0.301). Women in the treated HTN [OR = 0.61 (0.39–0.95)] and untreated HTN [0.54 (0.30–0.96)] groups had a lower odds of sexual activity compared with no HTN. There were no significant associations between antihypertensive medication class and sexual activity or problems in men or women.

Conclusion: The relationship between HTN and sexual health is different for older men and women. Prospective, comparative effectiveness trials are needed.

aSection of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine

bDepartment of Health Policy and Management

cDepartment of Chronic Disease Epidemiology, Yale School of Public Health

dRobert Wood Johnson Foundation Clinical Scholars Program and Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine

eCenter for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut

fDepartments of Obstetrics and Gynecology and Medicine-Geriatrics, The University of Chicago

gChicago Core on Biomeasures in Population-Based Aging Research, Center on Demography and Economics of Aging, The University of Chicago and NORC, Chicago, Illinois, USA

Correspondence to Erica S. Spatz, MD, MHS, Section of Cardiovascular Medicine, Yale University School of Medicine, 330 Cedar Street, Dana 3, New Haven, CT 06520-8088, USA. Tel: +1 203 785 6484; fax: +1 203 785 2715.e-mail:

Abbreviations: ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; HTN, hypertension; NSHAP, The National Social Health Life and Aging Project

Received 20 August, 2012

Revised 4 January, 2013

Accepted 6 February, 2013

© 2013 Lippincott Williams & Wilkins, Inc.