title: Selective adherence to antihypertensive medications as a patient-driven means to preserving sexual potency.
abstract: OBJECTIVE
  To describe hypertensive patients' experiences with sexual side effects and their consequences for antihypertensive medication adherence.
  
  
  METHODS
  Data were from a study conducted to identify facilitators of and barriers to adherence to blood pressure-lowering regimens. Participants were 38 married and unmarried veterans with a diagnosis of hypertension and 13 female spouses. Eight patient and four spouse focus groups were conducted. A directed approach to content analysis was used to determine the facilitators of and barriers to adherence. For this report, all discussion concerning the topic of sexual relations was extracted.
  
  
  RESULTS
  Male patients viewed sexual intercourse as a high priority and felt that a lack of sexual intercourse was unnatural. They pursued strategies to preserve their potency, including discontinuing or selectively adhering to their medications and obtaining treatments for impotence. In contrast, spouses felt that sexual intercourse was a low priority and that a lack of sexual intercourse was natural. They discouraged their husbands from seeking treatments for impotence.
  
  
  CONCLUSIONS
  Although the primary study was not designed to explore issues of sexual function, the issue emerged spontaneously in the majority of discussions, indicating that sexuality is important in this context for both male patients and their spouses. Physicians should address sexual side effects of antihypertensive medications with patients, ideally involving spouses.
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA;
authors.forename: Corrine I
authors.initials: CI
authors.lastname: Voils
authors.forename: Margarete
authors.initials: M
authors.lastname: Sandelowski
authors.forename: Philipp
authors.initials: P
authors.lastname: Dahm
authors.forename: Rachel
authors.initials: R
authors.lastname: Blouin
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
authors.forename: Eugene Z
authors.initials: EZ
authors.lastname: Oddone
authors.forename: Karen E
authors.initials: KE
authors.lastname: Steinhauser