Erectile dysfunction is frequently encountered in hypertensive patients. Along with blood pressure elevation, antihypertensive drugs have been implicated in the pathogenesis of erectile dysfunction. Although the effects of diuretics on erectile function seem detrimental, contradictory findings are available in the literature. We therefore aimed to evaluate the impact of diuretic therapy on erectile function in hypertensive patients without erectile dysfunction.
Design and method:
Consecutive male hypertensive patients between 30 and 70 years of age attending our Hypertension Outpatient Clinic who initiated diuretic therapy participated in the study. Erectile function was evaluated at baseline and three months after diuretic initiation. Erectile function was assessed using the International Index of Erectile Function, a validated 15-item questionnaire.
Overall, 247 male hypertensive patients participated in the study. Diuretic monotherapy was initiated in 56 participants, while diuretics were added to prior therapy in the rest 191 participants. From the latter group, 122 were on monotherapy with angiotensin receptor blockers and 69 were on dual therapy with angiotensin receptor blockers plus calcium antagonists. Erectile dysfunction appeared in 8/56 participants (14.2%) on diuretic monotherapy, in 27/122 participants (22.1%) on dual therapy with diuretics added to ARBs, and in 14/69 participants (20.3%) on triple therapy (diuretics on top of prior ARBs plus calcium antagonists administration).
Diuretic-induced erectile dysfunction is common among patients with arterial hypertension. Further studies are needed to verify our findings, enlighten the mediating mechanisms, and clarify the management of such patients.