Antihypertensive Drugs and the Sexually Active Hypertensive Male: Benefits of Losartan
AbstractBackground: Erectile dysfunction (ED) has made the initiations of therapy and continued therapy increasingly problematic in the management of the hypertensive male. There are reports suggesting beneficial effects of angiotensin II antagonists on sexual function. The effects of losartan on ED in Nigerian hypertensive men examined in a randomized clinical trial carried out on 42, newly diagnosed, untreated h ypertensive male patients in the University of Benin Teaching Hospital, Benin City, Nigeria between February 2008 and March, 2009.
Methodology: A structured, open ended questionnaire (using modified process of care model based on the international index of erectile function) was used to identify and recruit patients with ED. After routine screening procedures, patients were placed on antihypertensive drugs as follows: Group- A patients received losartan, an angiotensin II antagonist plus calcium channel blocker (CCB) and 40mg frusemide; Group-B patients received losartan only; Group- C1 patients received thiazide diuretics
(hydrochlothiazide or moduretic) and a CCB; and Group- D received ACEI (lisinopril or ramipril plus 40mg frusemide plus CCB for 8 weeks respectively. After 8 weeks, group- C1 (then C2) received losartan and CCB
and 40mg frusemide orally for another 8 week period.
Result: All the groups showed good blood pressure control though this was less marked in group B. Improvement of ED in groups A, B, and C2 was significantly higher than in C1and D, p<0.001.
Conclusion: Thus there is suggestion that the angiotensin II receptor blockers combinations may be a better alternative for the male hypertensive patients.