Question:
I may have to go on meds for high blood pressure. 30 years ago they
were notorious for causing ED. Does anyone know anything good or bad
about the current ones?
Answer:
Yes, some anti-hypertensives (AH) do cause ED, most suspect are calcium
channel blockers and beta blockers. The good news is that there are two
classes of anti-hypertensives that actually improve erectile function. The
first class is the alpha blockers. Unfortunately, the concurrent use of
alpha blockers and ED drugs like Viagra are contraindicated. If you are not
on ED drugs, this might be a good choice.
The second class of AH drugs that has been shown to improve erectile
function is the angiotensin II antagonists. Specifically, Losartin may be
the best choice in this class. These drugs are not contraindicated with ED
meds to my knowledge. The have not only have been shown to reverse ED, but
to improve cognitive function in older patients and have beneficial
properties for protecting cardiac and renal structures. Here are a couple
of articles that you should discuss with you physician:
All Antagonists in Hypertension, Heart Failure, and Diabetic Nephropathy:
Focus on Losartan
http://www.medscape.com/viewarticle/472665_1
"Several AIIAs (losartan and valsartan) have been shown to produce favorable
effects on sexual function,[144-146] most likely due to their ability to
block Ang II, a mediator of erectile function.124 Losartan treatment for 12
weeks produced marked and statistically significant increases in sexual
satisfaction from 7.3% of patients at baseline to 58.5% of patients after
losartan (p < 0.001), and also positively affected several other indices of
sexual dysfunction, including erectile function, frequency of sexual
activity, as well as perceived quality of life.[144] In LIFE, a
losartan-based antihypertensive regimen was also associated with
significantly fewer reports of sexual dysfunction compared with an
atenolol-based regimen, although the difference was small (4 vs. 5%,
respectively, p = 0.009).[31]"
The Choice of Antihypertensive Drugs in Patients With Erectile Dysfunction
http://www.medscape.com/viewarticle/439675_1
"It is well established that hypertension and the more traditional
anti-hypertensive drugs are associated with erectile dysfunction (ED). There
is evidence showing that two antihypertensive drugs - doxazosin and
losartan - have a positive effect on erectile function. Therefore these
drugs may decrease the incidence of ED in patients who need treatment for
hypertension. Doxazosin and/or losartan can also be beneficial in patients
who develop ED after starting treatment with other antihypertensive drugs.
These options could, in turn, ensure better compliance and blood pressure
control. A fall in the overall cost of treatment will also be anticipated if
there is a reduced need for drugs prescribed for ED in patients with
hypertension."
