Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT 06520-8088, USA.
J Hypertens. 2013 Jun;31(6):1096-105. doi: 10.1097/HJH.0b013e32835fdefa.
To determine the association of hypertension (HTN) and its treatment with sexual function in middle-aged and older adults.
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.
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.
The relationship between HTN and sexual health is different for older men and women. Prospective, comparative effectiveness trials are needed.
确定高血压（HTN）及其治疗与中年和老年人性功能之间的关系。
我们研究了来自国家社会健康、生活和老龄化项目的 57-85 岁社区居住成年人的全国代表性样本（n=3005）。成年人根据 HTN 状况（治疗、未治疗和无 HTN）进行分类。抗高血压药物使用分为钙通道阻滞剂；β受体阻滞剂；血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂；利尿剂；和α受体阻滞剂。对于每个 HTN 和药物组，我们确定了性行为活跃和存在任何性功能障碍的患病率和调整后的比值比。
在男性中，与未治疗的 HTN 和无 HTN 相比，治疗性 HTN 的性行为活跃度较低（66.5%比 75.9%比 71.5%，P<0.01），性功能障碍更为常见（69.1%比 57.7%比 54.3%；P≤0.01）。治疗性 HTN 与性行为之间没有关联[比值比，OR=0.86（95%置信区间 0.51-1.45)]，与性功能障碍之间也没有显著关联[OR=1.49（0.94-2.37）]。在女性中，治疗和未治疗的 HTN 组的性行为活跃度低于无 HTN 组（35.2%比 38.3%比 58.0%，P<0.01）；性功能障碍的发生率相似（73.7%比 65.3%比 71.7%；P=0.301）。与无 HTN 相比，治疗性 HTN [OR=0.61（0.39-0.95）]和未治疗性 HTN [0.54（0.30-0.96）]的女性性行为活跃度较低。在男性和女性中，降压药物类别与性行为或性功能障碍之间没有显著关联。
HTN 与老年男性和女性的健康之间的关系不同。需要进行前瞻性、比较有效性试验。
