title: Sexual activity and function among middle-aged and older men and women with hypertension.
abstract: OBJECTIVE
  To determine the association of hypertension (HTN) and its treatment with sexual function in middle-aged and older adults.
  
  
  METHODS
  We studied a nationally representative sample of community-residing adults aged 57-85 years (n = 3005) from the National Social Health, Life and Aging Project. Adults were categorized by HTN status (treated, untreated, and no HTN). Antihypertensive medication use was classified into calcium channel blocker; β-blocker; angiotensin-converting enzyme inhibitor/angiotensin receptor blocker; diuretic; and α-blocker. For each HTN and medication group, we determined the prevalence and adjusted odds of being sexually active and of having any sexual problem.
  
  
  RESULTS
  Among men, comparing treated HTN with untreated HTN and no HTN, sexual activity was less prevalent (66.5 vs. 75.9 vs.71.5%, P <0.01) and sexual problems were more prevalent (69.1 vs. 57.7 vs. 54.3%; P ≤ 0.01). There was no association between treated HTN and sexual activity [odds ratio, OR = 0.86 (95% confidence interval 0.51-1.45)] and a nonsignificant association between treated HTN and sexual problems [OR = 1.49 (0.94-2.37)]. Among women, the prevalence of sexual activity was lower in the treated and untreated HTN groups than the no HTN group (35.2 vs. 38.3 vs. 58.0%, P <0.01); the prevalence of sexual problems was similar (73.7 vs. 65.3 vs. 71.7%; P = 0.301). Women in the treated HTN [OR = 0.61 (0.39-0.95)] and untreated HTN [0.54 (0.30-0.96)] groups had a lower odds of sexual activity compared with no HTN. There were no significant associations between antihypertensive medication class and sexual activity or problems in men or women.
  
  
  CONCLUSIONS
  The relationship between HTN and sexual health is different for older men and women. Prospective, comparative effectiveness trials are needed.
authors: Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT 06520-8088, USA. erica.spatz@yale.edu
authors: Erica S
authors: ES
authors: Spatz
authors: Maureen E
authors: ME
authors: Canavan
authors: Mayur M
authors: MM
authors: Desai
authors: Harlan M
authors: HM
authors: Krumholz
authors: Stacy T
authors: ST
authors: Lindau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D014481:United States
chemical_list: D000959:Antihypertensive Agents
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