Frequency of Iatrogenic Sexual Dysfunction Associated with Antihypertensive Compounds

Journal of Clinical Medicine

María Elena Sánchez-Sánchez¹  Angel L. Montejo¹  José Mª. Acosta¹  Nieves Prieto¹  Bárbara Buch-Vicente¹  José-Angel Martín-Oterino²  Purificación Galindo-Villardón³ 

[1] Instituto Investigación Biomédica de Salamanca (IBSAL), Paseo San Vicente SN, 37007 Salamanca, Spain;Internal Medicine Service, Clinical Hospital of Salamanca, Paseo San Vicente SN, 37007 Salamanca, Spain;Statistical Department, Campus Miguel de Unamuno, University of Salamanca, Calle Alfonso X El Sabio s/n, 37007 Salamanca, Spain;

关键词: sexual dysfunction;    antihypertensive treatment;    hypertension;    PRSexDQ-SALSEX;    blood pressure;   

DOI  :  10.3390/jcm10225214

来源: DOAJ

【 摘 要 】

Iatrogenic sexual dysfunction (SD) caused by antihypertensive (AH) compounds, provoking sexual desire, orgasm or arousal dysfunction, is a common clinical adverse event. Unfortunately, it is often underestimated and underreported by clinicians and prescribers in clinical practice, deteriorating the adherence and patient quality of life. The objective of this study was to investigate the frequency of SD in patients treated with different antihypertensive compounds; a real-life naturalistic and cross-sectional study in patients receiving AH treatment was carried out. Method: A total of 256 patients were included in the study (188 males and 68 females who met the inclusion and exclusion criteria). The validated Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SALSEX) was transversally applied once at least every two months following the onset of the treatment in order to measure possible AH-related SD. Although the spontaneous reporting of SD was very low (6.81% females/24.8% males), 66.40% of the patients reported impaired sexual function through the SALSEX questionnaire after the treatment onset, as follows: decreased desire (55.8% females/54.2% males), delayed orgasm (42.6%/45.7%), anorgasmia (42.6%/43.6%) and arousal difficulties (53%/59.6%). The average frequency of moderate to severe iatrogenic SD was 66.4% with AH in monotherapy as follows: angiotensin II receptor antagonists (ARBs), 29.8%; calcium antagonists, 40%; diuretics, 42.9%; beta blockers, 43.8%; and angiotensin-converting enzyme (ACE) inhibitors, 77.8%. Combined treatments showed a higher percentage of main SD (70.3%): diuretic + ACE inhibitor, 42.3%; ARB + calcium antagonist, 55.6%; diuretic + calcium antagonist, 68.8%; and diuretic + ARB, 74.2%. The greatest risk factors associated with SD were poor general health, age over 60 with a comorbid coronary or musculoskeletal disease, mood disorder and diuretic +ARB combined therapy. Conclusion: SD is common in patients treated with antihypertensive drugs, and it is still underreported. The most harmful treatment deteriorating sexual function was the combination of diuretic +ARB, while the least harmful was monotherapy with ARBs. More research is needed on the clinical management of this problem to preserve the quality of life of patients and their partners.

【 授权许可】

Unknown