title: Erectile dysfunction may improve by blood pressure control in patients with high-risk hypertension.
abstract: BACKGROUND
  Blood pressure (BP) control induces reductions in target-organ damage and cardiovascular events. Erectile dysfunction (ED) is a multifactorial disease related to cardiovascular disease, but its relationship with BP control has not been extensively studied.
  
  
  OBJECTIVE
  We describe the effect of BP control on ED in patients with high-risk hypertension who were treated with beta-blockers.
  
  
  METHODS
  This was a cross-sectional and observational study of male patients with hypertension treated with any beta-blocking agent for ≥ 6 months. Erectile dysfunction was assessed by the International Index of Erectile Function (IIEF). Statistical analysis was performed using a Chi-square test, Fisher's exact test, covariance analysis, and stepwise logistic regressions.
  
  
  RESULTS
  A total of 1242 patients were studied; 33.7% had controlled BP. Patients with uncontrolled BP had slightly higher mean age (64.4 years vs 58.6 years) and higher prevalence of diabetes and cardiac and noncardiac comorbidities. Patients with controlled BP had a lower crude and adjusted prevalence of ED. Erectile dysfunction was significantly lower in patients with controlled BP in the 2 older age quartiles (> 59 years). Multivariate analyses, adjusted by age, clinical features, and medical treatments were conducted separately in patients within the 2 younger and older age quartiles. In patients in the 2 younger quartiles, ED was only independently and inversely associated with nebivolol treatment (odds ratio [OR], 0.22; 95% confidence interval [CI], 0.05-0.88). Conversely, BP control (OR, 0.48; 95% CI, 0.26-0.89), diabetes (OR, 2.64; 95% CI, 1.32-5.28), and peripheral artery disease (OR, 3.80; 95% CI, 1.20-12.00) were independently associated with ED in patients in the older 2 age quartiles.
  
  
  CONCLUSIONS
  In patients with high-risk hypertension treated with beta-blockers, BP control was associated with a lower prevalence of ED, independently of age, cardiovascular disease, and medical treatments. The effect of BP control was higher in older patients.
authors.affiliation: Department of Cardiology, Hospital Universitario de San Juan, Alicante, Spain. acorderofort@gmail.com
authors.forename: Alberto
authors.initials: A
authors.lastname: Cordero
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu-Martínez
authors.forename: Pilar
authors.initials: P
authors.lastname: Mazón
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fácila
authors.forename: José Ramón
authors.initials: JR
authors.lastname: González-Juanatey
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D017677:Age Distribution; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents