ExcelMale
Menu
Home
What's new
Latest activity
Forums
New posts
Search forums
What's new
New posts
Latest activity
Videos
Lab Tests
Doctor Finder
Buy Books
About Us
Men’s Health Coaching
Log in
Register
What's new
Search
Search
Search titles only
By:
New posts
Search forums
Menu
Log in
Register
Navigation
Install the app
Install
More options
Contact us
Close Menu
Forums
Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
Hypertension and erectile dysfunction: breaking down the challenges
JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding.
You are using an out of date browser. It may not display this or other websites correctly.
You should upgrade or use an
alternative browser
.
Reply to thread
Message
<blockquote data-quote="madman" data-source="post: 198157" data-attributes="member: 13851"><p><strong><span style="font-size: 18px">Antihypertensive drugs: a double-edged sword challenge</span></strong></p><p></p><p><em>Hypertension, in most cases, can be controlled with antihypertensive agents, which are frequently associated with undesirable side effects, including ED. The relationship between antihypertensive medications and ED has been extensively studied, largely because it might affect the adherence to the prescribed therapy regimen resulting in poor management of blood pressure.</em></p><p><em></em></p><p><em>In a recent review, Doumas, Boutari, and Viigimma insightfully debated the interplay between antihypertensive drugs and ED. As they discussed, there is evidence that some antihypertensive medications, including diuretics, beta-blockers, and centrally acting agents, can negatively impact erectile function independently of the fact that these drugs are lowering blood pressure. Between these drugs, <strong>diuretics and alpha-blockers are the ones most often associated with ED. </strong>While the mechanism by which diuretics affect erectile function is not entirely clear, it seems that beta-blockers, especially the non-selective ones, contribute to ED by blocking beta-2 receptors, which consequently leads to a higher degree of constriction in penile arteries. Additionally, a study reported lower testosterone levels in hypertensive men treated with atenolol. Noteworthy, the literature is not cohesive, and conflicting findings have been reported, including a study suggesting that when a patient knows about the link between beta-blockers and ED, this can lead to anxiety, which might cause ED. Interestingly,<strong> nebivolol, a third-generation beta-blocker with a higher affinity for beta-1 receptors, has a positive effect on the erectile response</strong>. In fact, it reverses erectile dysfunction in a murine model of diabetes, which could be explained by the fact that nebivolol stimulates eNOS activity because it has antioxidant properties. Intricate results are also observed when comparing the effects of Ang-II receptor blockers (ARBs) and ACE inhibitors as ARBs appear to have beneficial effects, whereas ACE inhibitors have a neutral impact on this parameter. As previously discussed, an increase in the expression levels of Ang-II directly impacts erectile function. Therefore, while the results obtained with ARBs are somewhat expected, the neutral results acquired with ACE inhibitors are counterintuitive. Such results might occur in response to the partial blockade of Ang-II production. Thus,<strong> further studies are needed to clarify the impact of ACE inhibitors on erectile function.</strong></em></p><p><em></em></p><p><em>This topic, the use of antihypertensive drugs, is of particular interest because drugs used to treat ED target the enzyme PDE5, and therefore, rely on endogenous NO production. While PDE5 inhibitors have been shown to be a safe pharmacological approach in hypertensive patients taking antihypertensive drugs, as we discussed above, these patients have reduced availability of NO, and consequently, they might not fully benefit from the use of PDE5 inhibitors. In fact, <strong>PDE5 inhibitors are ineffective for approximately 30% of the cases, and the presence of comorbid conditions, such as hypertension, negatively affects the drug outcomes</strong>. Undoubtedly,<strong> the management of hypertension and ED represents a double-edged sword challenge</strong> in the clinical setting where physicians have to balance optimal blood pressure control and patient compliance while preserving the quality of life of sexually active patients.</em></p></blockquote><p></p>
[QUOTE="madman, post: 198157, member: 13851"] [B][SIZE=18px]Antihypertensive drugs: a double-edged sword challenge[/SIZE][/B] [I]Hypertension, in most cases, can be controlled with antihypertensive agents, which are frequently associated with undesirable side effects, including ED. The relationship between antihypertensive medications and ED has been extensively studied, largely because it might affect the adherence to the prescribed therapy regimen resulting in poor management of blood pressure. In a recent review, Doumas, Boutari, and Viigimma insightfully debated the interplay between antihypertensive drugs and ED. As they discussed, there is evidence that some antihypertensive medications, including diuretics, beta-blockers, and centrally acting agents, can negatively impact erectile function independently of the fact that these drugs are lowering blood pressure. Between these drugs, [B]diuretics and alpha-blockers are the ones most often associated with ED. [/B]While the mechanism by which diuretics affect erectile function is not entirely clear, it seems that beta-blockers, especially the non-selective ones, contribute to ED by blocking beta-2 receptors, which consequently leads to a higher degree of constriction in penile arteries. Additionally, a study reported lower testosterone levels in hypertensive men treated with atenolol. Noteworthy, the literature is not cohesive, and conflicting findings have been reported, including a study suggesting that when a patient knows about the link between beta-blockers and ED, this can lead to anxiety, which might cause ED. Interestingly,[B] nebivolol, a third-generation beta-blocker with a higher affinity for beta-1 receptors, has a positive effect on the erectile response[/B]. In fact, it reverses erectile dysfunction in a murine model of diabetes, which could be explained by the fact that nebivolol stimulates eNOS activity because it has antioxidant properties. Intricate results are also observed when comparing the effects of Ang-II receptor blockers (ARBs) and ACE inhibitors as ARBs appear to have beneficial effects, whereas ACE inhibitors have a neutral impact on this parameter. As previously discussed, an increase in the expression levels of Ang-II directly impacts erectile function. Therefore, while the results obtained with ARBs are somewhat expected, the neutral results acquired with ACE inhibitors are counterintuitive. Such results might occur in response to the partial blockade of Ang-II production. Thus,[B] further studies are needed to clarify the impact of ACE inhibitors on erectile function.[/B] This topic, the use of antihypertensive drugs, is of particular interest because drugs used to treat ED target the enzyme PDE5, and therefore, rely on endogenous NO production. While PDE5 inhibitors have been shown to be a safe pharmacological approach in hypertensive patients taking antihypertensive drugs, as we discussed above, these patients have reduced availability of NO, and consequently, they might not fully benefit from the use of PDE5 inhibitors. In fact, [B]PDE5 inhibitors are ineffective for approximately 30% of the cases, and the presence of comorbid conditions, such as hypertension, negatively affects the drug outcomes[/B]. Undoubtedly,[B] the management of hypertension and ED represents a double-edged sword challenge[/B] in the clinical setting where physicians have to balance optimal blood pressure control and patient compliance while preserving the quality of life of sexually active patients.[/I] [/QUOTE]
Insert quotes…
Verification
Post reply
Share this page
Facebook
Twitter
Reddit
Pinterest
Tumblr
WhatsApp
Email
Share
Link
Sponsors
Forums
Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
Hypertension and erectile dysfunction: breaking down the challenges
This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
By continuing to use this site, you are consenting to our use of cookies.
Accept
Learn more…
Top