Anti-hypertensive medications and erectile dysfunction: focus on β-blockers

IF 3.7 3区 医学 Q2 Medicine Endocrine Pub Date : 2024-09-13 DOI:10.1007/s12020-024-04020-x
G. Corona, W. Vena, A. Pizzocaro, G. Salvio, C. Sparano, A. Sforza, M. Maggi
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Abstract

Purpose

Although anti-hypertensive medications, including thiazides and β-blockers (BBs) in particular, have been suggested to cause erectile dysfunction (ED) their real contribution is still conflicting. The aim of this paper is to summarize available evidence providing an evidence-based critical analysis of the topic.

Methods

An overall comprehensive narrative review was performed using Medline, Embase and Cochrane search. In addition, to better understand the impact of BBs on ED a specific systematic review was also performed.

Results

The negative role of centrally acting drugs, such as clonidine and α-methyldopa, is well documented althuogh limited controlled trials are available. Angiotensin-converting enzyme inhibitors (ACEis), angiotensin receptor blockers (ARBs), and calcium-channel-blockers (CCBs) have neutral (CCBs) or even positive (ACEis and ARBs) effects on erectile function. Despite some preliminary negative reports, more recent evidence does not confirm the negative impact of thiazides. BBs should be still considered the class of medications more often associated with ED, although better outcomes can be drawn with nebivolol.

Conclusion

Sexual function should be assessed in all patients with arterial hypertension, either at diagnosis or after the prescription of specific medications. A close related patient-physician interaction and discussion can overcome possible negative outcomes allowing a successful management of possible side effects.

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抗高血压药物与勃起功能障碍:关注 β 受体阻滞剂
目的尽管包括噻嗪类和β-受体阻滞剂(BBs)在内的抗高血压药物被认为可导致勃起功能障碍(ED),但其真正的作用仍存在争议。本文旨在总结现有证据,对这一主题进行基于证据的批判性分析。方法使用 Medline、Embase 和 Cochrane 进行了全面的综述。此外,为了更好地了解BBs对ED的影响,还进行了一项专门的系统综述。结果中枢作用药物(如氯尼丁和α-甲基多巴)的负面作用已得到充分证实,但可获得的对照试验有限。血管紧张素转换酶抑制剂(ACEis)、血管紧张素受体阻滞剂(ARBs)和钙通道阻滞剂(CCBs)对勃起功能的影响为中性(CCBs),甚至为阳性(ACEis 和 ARBs)。尽管有一些初步的负面报道,但最近的证据并未证实噻嗪类药物的负面影响。尽管奈必洛尔(nebivolol)可以取得更好的疗效,但BB类药物仍应被视为最常与ED相关的一类药物。密切相关的医患互动和讨论可以克服可能出现的负面结果,从而成功控制可能出现的副作用。
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来源期刊
Endocrine
Endocrine 医学-内分泌学与代谢
CiteScore
6.40
自引率
5.40%
发文量
0
期刊介绍: Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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