A study presented at the ESC Congress 2020 Conference has warned that BP medicines can hamper the sex lives of individuals who have normal or near-normal blood pressure (pre-hypertension), as the drugs can affect penile blood flow and set off erectile dysfunction.
Charalambos Vlachopoulos, the study author said, "The results imply that hypertensive patients already have significant structural damage in the penile arteries and adding antihypertensive drugs does not further reduce penile blood flow. But in men with normal or high-normal blood pressure, the penile arteries have minimal structural damage and medications could have a negative impact on penile blood flow."
Arterial Damage Affects Penile Blood Flow
For men with untreated hypertension, older BP medications (beta blockers and diuretics) are not ideal and should be used only if absolutely indicated, said Vlachopoulos. Men with untreated high blood pressure have poorer penile blood flow than those with normal blood pressure, according to the study.
Hypertension (high blood pressure) affects more than one billion people worldwide and is the leading cause of premature death. Men with hypertension were almost twice as likely to have impaired penile blood flow and erectile dysfunction compared to men with normal blood pressure, increasing their risk of heart diseases and death.
High blood pressure damages artery walls causing them to harden and narrow and reduces blood flow to the penis. Erectile dysfunction is an early warning sign of damaged blood vessels. However, previous studies have shown that erectile dysfunction is more common in treated than untreated men with high BP.
Certain antihypertensive drugs -- notably diuretics and beta blockers -- have been linked with deterioration in sexual function. This study examined the association between blood pressure level and penile blood flow and whether blood pressure-lowering medication had an effect on the relationship.
The study included 356 men with erectile dysfunction and no history of diabetes or cardiovascular diseases. The cohort was divided into three categories according to blood pressure -- normal, high-normal and hypertension. As many as 164 (nearly 46 percent) patients were being treated with antihypertensive medications.
Among men not receiving antihypertensive medication, penile blood flow velocity progressively decreased with rising blood pressure -- blood flow was fastest in those with normal blood pressure, slower in those with high-normal blood pressure and slowest in those with hypertension.
In contrast, among men taking antihypertension therapy, there was no difference in penile blood flow velocity between the three blood pressure categories. "The progressive decrease in penile blood flow velocity across the three blood pressure categories in men not taking antihypertensive medication indicates significant structural changes in the penile blood vessels from longstanding hypertension," Vlachopoulos said.
Lack of Requirement of Medication for Treatment
The blood flow differences across the three blood pressure categories disappeared with treatment suggesting a medication effect. An additional analysis compared treated and untreated men within each blood pressure group.
In the hypertension category, treated and untreated patients had similar penile blood flow velocities. However, in the high-normal (prehypertension) category, treated men had worse penile blood flow than untreated men.
Similarly, in the normal blood pressure category, treated men had worse penile blood flow than untreated men. "Our study shows that high blood pressure can be treated without causing erectile dysfunction. Patients and doctors need to have open discussions to find the best treatment option," the authors said.
(With inputs from agencies)