Effect of antihypertensives on sexual function and quality of life: the TAIM Study.
OBJECTIVE
To evaluate treatment of mild hypertension using combinations of diet and low-dose pharmacologic therapies.


METHODS
Multicenter, randomized, placebo-controlled clinical trial.


METHODS
Three university-based tertiary care centers.


METHODS
Patients (697) 21 to 65 years of age with diastolic blood pressure between 90 and 100 mm Hg as well as weight between 110% and 160% of ideal weight.


METHODS
Patients were stratified by clinical center and race and were randomly assigned to one of three diets (usual, low-sodium and high-potassium, weight loss) and one of three agents (placebo, chlorthalidone, and atenolol).


METHODS
Changes in measures of sexual problems, distress, and well-being after 6 months of therapy were analyzed.


RESULTS
Low-dose chlorthalidone and atenolol produced few side effects, except in men. Erection-related problems worsened in 28% (95% CI, 15% to 41%) of men receiving chlorthalidone and usual diet compared with 3% (CI, 0% to 9%) of those receiving placebo and usual diet (P = 0.009) and 11% (CI, 2% to 20%) of those receiving atenolol and usual diet (P greater than 0.05). The weight loss diet ameliorated this effect. The low-sodium diet with placebo was associated with greater fatigue (34%; CI, 23% to 45%) than was either usual diet (18%; CI, 10% to 27%; P = 0.04) or weight reduction (15%; CI, 7% to 23%; P = 0.009). The low-sodium diet with chlorthalidone increased problems with sleep (32%; CI, 22% to 42%) compared with chlorthalidone and usual diet (16%; CI, 8% to 24%; P = 0.04). The weight loss diet benefited quality of life most, reducing total physical complaints (P less than 0.001) and increasing satisfaction with health (P less than 0.001). Total physical complaints decreased in 57% to 76% of patients depending on drug and diet group, and were markedly decreased by weight loss.


CONCLUSIONS
In general, low-dose antihypertensive drug therapy (with chlorthalidone or atenolol) improves rather than impairs the quality of life; however, chlorthalidone with usual diet increases sexual problems in men.
Wassertheil-Smoller
S
S
Albert Einstein College of Medicine, Bronx, NY 10461.
Blaufox
M D
MD
Oberman
A
A
Davis
B R
BR
Swencionis
C
C
Knerr
M O
MO
Hawkins
C M
CM
Langford
H G
HG
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects*; D002752:Chlorthalidone / Q000009:adverse effects; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004035:Diet Therapy / Q000009:adverse effects; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced / Q000209:etiology*; D013223:Statistics as Topic
D000959:Antihypertensive Agents; D002752:Chlorthalidone