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.