Self Reported Sexual Dysfunction in Men and Women Treated With Bisoprolol, Hydrochlorothiazide, Enalapril, Amlodipine, Placebo, or Bisoprolol/Hydrochlorothiazide.
Quality of life may be impaired by antihypertensive therapy. Perceived sexual dysfunction by antihypertensive drugs diminishes quality of life and results in noncompliance with antihypertensive therapy. To assess the impact of various classes of antihypertensive therapy vs. combination therapy, self reported adverse reactions were catalogued by gender using COSTART (Coding Symbols for Thesaurus of Adverse Reaction Terms) of impotence or libido decrease in six randomized, blinded, prospective trials in which subjects received placebo, 5 mg qd-20 mg bid enalapril, 2.5-10 mg qd amlodipine, 6.25-25 mg qd hydrocholorothiazide (HCTZ), bisoprolol 5 mg qd, or a combination of 2.5-10 mg qd bisoprolol/6.25 mg HCTZ. The average duration of drug exposure was 6-14 weeks (range of 1 day to 23 weeks). Comparison among groups was performed using Fisher's exact test. There was no statistical difference between treatment with respect to impotence (p equals 0.688), decrease in libido (p equals 0.970), or overall sexual dysfunction (p equals 0.705) for 1251 men. Of the 661 women studied, decrease in libido was reported in only two subjects. It is concluded that short term exposure to antihypertensive drugs is associated with self reported impotence at no greater prevalence than it is with placebo in men. The combination of bisoprolol/6.25 mg HCTZ is not more likely to be associated with sexual dysfunction than placebo, HCTZ, bisoprolol, enalapril, or amlodipine. Also sexual dysfunction is reported less frequently in women than men. (c)1999 by Le Jacq Communications, Inc.
Prisant
L. Michael
LM
Hypertension Unit, Section of Cardiology, Medical College of Georgia, Augusta, GA.
Weir
Matthew R.
MR
Frishman
William H.
WH
Neutel
Joel M.
JM
Davidov
Michael E.
ME
Lewin
Andrew J.
AJ