title: Effect of felodipine with irbesartan or metoprolol on sexual function and oxidative stress in women with essential hypertension.
abstract: OBJECTIVE
  To evaluate the impact of felodipine with irbesartan on sexual function compared with felodipine with metoprolol in hypertensive women.
  
  
  METHODS
  This was a prospective, randomized, parallel, active-controlled, open-label study (ClinicalTrials.org: NCT01238705) in 160 women (18-60 years) with mild or moderate hypertension, randomized to a once-daily treatment with felodipine combined with irbesartan or metoprolol for 48 weeks. Patients' sexual function was evaluated using a female sexual function index (FSFI) questionnaire at baseline and after 24 and 48 weeks of therapy. Levels of serum estradiol, testosterone, 8-hydroxy-2'-deoxyguanosine (8-OHdG), 4-hydroxynonenal (4-HNE) and malondialdehyde (MDA) were measured.
  
  
  RESULTS
  The two combination regimens were similarly effective in lowering blood pressure. After 48 weeks, in felodipine-irbesartan group, total scores of FSFI improved (P < 0.001). Items showing improvement in scores corresponded to desire, arousal and orgasm (P < 0.001; P = 0.002; P = 0.049, respectively). Levels of estradiol increased under treatment with felodipine-irbesartan (P = 0.003) and decreased under felodipine-metoprolol treatment (P < 0.001). The concentration of testosterone declined after felodipine-irbesartan therapy (P < 0.001) and increased under felodipine-metoprolol treatment (P < 0.001). In the felodipine-irbesartan group, decreases of 8-OHdG, 4-HNE (P < 0.001) and MDA (P < 0.001) were observed. The felodipine-irbesartan combination resulted in less oxidative stress. The differences in changes in 8-OHdG, 4-HNE and MDA between the two groups were significant (P < 0.05).
  
  
  CONCLUSIONS
  These results suggested that the felodipine-irbesartan combination regimen improved sexual function in hypertensive women, whereas felodipine-metoprolol regiment did not. The reason for the different influence of these two combination therapy on female sexual function might be their different impacts on oxidative stress and hormone levels.
authors: Section of Cardiology, Second Hospital of Lanzhou University, Lanzhou, Gansu Province, China.
authors: Ruixin
authors: R
authors: Ma
authors: Jing
authors: J
authors: Yu
authors: Dian
authors: D
authors: Xu
authors: Longquan
authors: L
authors: Yang
authors: Xin
authors: X
authors: Lin
authors: Feng
authors: F
authors: Zhao
authors: Feng
authors: F
authors: Bai
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001713:Biphenyl Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015736:Felodipine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D000077405:Irbesartan; D008790:Metoprolol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D011446:Prospective Studies; D019529:Sexuality / Q000187:drug effects*; D013777:Tetrazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D013777:Tetrazoles; D008790:Metoprolol; D000077405:Irbesartan; D015736:Felodipine