New England Research Institutes, Watertown, MA, USA.
BJU Int. 2013 Dec;112(8):1178-87. doi: 10.1111/bju.12231. Epub 2013 Jul 2.
To investigate the association of erectile dysfunction (ED) with commonly used medications including antihypertensive treatment (AHT), psychoactive medication and pain and anti-inflammatory medication.
The Boston Area Community Health (BACH) survey used a multistage stratified design to recruit a random sample of 2301 men aged 30-79 years. ED was assessed using the five-item International Index of Erectile Function (IIEF-5). Prescription medications, captured using a combination of drug inventory and self-report with a prompt by indication, included in this analysis comprised AHT, psychoactive medication, and pain and anti-inflammatory medication. Logistic regression was used to estimate the odds ratios (ORs) of the association of medication use with ED and to adjust for potential confounders including age, comorbid conditions and sociodemographic and lifestyle factors.
Multivariable analyses showed benzodiazepines (adjusted OR = 2.34, 95% confidence interval [CI]: 1.03, 5.31) and tricyclic antidepressants (adjusted OR = 3.35, 95% CI: 1.09, 10.27) were associated with ED, while no association was observed for serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors and atypical antipsychotics. The use of AHT, whether in monotherapy or in conjunction with other AHTs, and pain or anti-inflammatory medications were not associated with ED after accounting for confounding factors.
Results of the BACH survey suggest adverse effects of some psychoactive medications (benzodiazepines and tricyclic antidepressants). No evidence of an association of AHT or pain and anti-inflammatory medication with ED was observed.
研究勃起功能障碍(ED)与常用药物的关联,包括降压治疗(AHT)、精神药物和疼痛及抗炎药物。
波士顿地区社区健康(BACH)调查采用多阶段分层设计,招募了 2301 名年龄在 30-79 岁的随机样本男性。ED 采用国际勃起功能指数(IIEF-5)的五分量表进行评估。本分析中包含的处方药物,通过药物清单和自我报告的结合,以及根据指征的提示进行捕获,包括 AHT、精神药物和疼痛及抗炎药物。使用逻辑回归来估计药物使用与 ED 的关联的比值比(OR),并调整潜在的混杂因素,包括年龄、合并症以及社会人口学和生活方式因素。
多变量分析显示,苯二氮䓬类(调整后的 OR = 2.34,95%置信区间[CI]:1.03,5.31)和三环类抗抑郁药(调整后的 OR = 3.35,95% CI:1.09,10.27)与 ED 相关,而与 5-羟色胺再摄取抑制剂/去甲肾上腺素再摄取抑制剂和非典型抗精神病药无关联。在考虑混杂因素后,AHT 的使用(无论是单药治疗还是与其他 AHT 联合使用)以及疼痛或抗炎药物与 ED 无关。
BACH 调查的结果表明一些精神药物(苯二氮䓬类和三环类抗抑郁药)存在不良反应。未观察到 AHT 或疼痛及抗炎药物与 ED 相关的证据。