Hypertension as a Risk for Erectile Dysfunction: Implications for Sildenafil Use.

Hypertension is one of several risk factors for erectile dysfunction. Others include the cardiovascular risk factors of low levels of high density lipoprotein, high total cholesterol, smoking, and diabetes. Certain antihypertensive drugs, especially the thiazide diuretics, can contribute to erectile dysfunction. Sildenafil is the first oral agent available for the treatment of erectile dysfunction. It works in patients with psychogenic as well as organic erectile dysfunction, including men with hypertension and men on antihypertensive medicines. Sildenafil alone causes small drops in systolic and diastolic blood pressure. When administered to patients on antihypertensive drugs it was again associated with small drops in arterial pressure and no increase in adverse events compared to patients not taking antihypertensive drugs. When sildenafil is given in the setting of organic nitrates (nitric oxide donors), large falls in blood pressure may occur. Sildenafil is absolutely contraindicated in the setting of organic nitrate use. (c)2000 by Le Jacq Communications, Inc.