Suzuki H, Tominaga T, Kumagai H, Saruta T
Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
J Hypertens Suppl. 1988 Dec;6(4):S649-51. doi: 10.1097/00004872-198812040-00204.
We studied sexual dysfunction induced by antihypertensive agents in 156 male hypertensive patients. The antihypertensive agents were: trichloromethiazide, 2-4 mg; atenolol, 50-100 mg; captopril 37.5-75 mg; and slow release nifedipine 40-80 mg, administered every day for 1 year after a 2-4-week placebo period. Sexual dysfunction was checked by both a self-reporting questionnaire and a test for serum sex hormones. In the self-reporting questionnaire, the following items were requested: reduction of sexual desire, problems in obtaining and maintaining an erection, problems in ejaculation and the number of occasions of sexual intercourse. The sex hormones measured were testosterone, follicular stimulating hormone, luteinizing hormone and oestradiol. During the placebo period, 5% of the hypertensive patients complained of some sexual disturbance without any significant changes in the plasma levels of the sex hormones. In the short term (1-4 weeks) after the initiation of the antihypertensive therapy, all antihypertensive agents except captopril caused sexual dysfunction. Patients on atenolol or trichloromethiazide complained of every item listed. Those on slow-release nifedipine complained mainly about problems in ejaculation. Serum levels of both testosterone and follicular stimulating hormone were significantly decreased while there was mild elevation of oestradiol in patients on atenolol. In the long term (1 year), only patients taking atenolol experienced sexual dysfunction and mild reduction of serum levels of testosterone. Our findings show that first-line antihypertensive agents have different effects on sexual function and that only captopril may have some advantages over the other agents in terms of the quality of sexual life.
我们研究了156例男性高血压患者中由抗高血压药物引起的性功能障碍。抗高血压药物包括：三氯噻嗪，2 - 4毫克；阿替洛尔，50 - 100毫克；卡托普利37.5 - 75毫克；以及缓释硝苯地平40 - 80毫克，在经过2 - 4周的安慰剂期后，每天服用，持续1年。通过自我报告问卷和血清性激素检测来检查性功能障碍。在自我报告问卷中，要求填写以下项目：性欲减退、勃起功能障碍、射精问题以及性交次数。所检测的性激素有睾酮、促卵泡生成素、黄体生成素和雌二醇。在安慰剂期，5%的高血压患者抱怨有一些性方面的困扰，而性激素的血浆水平无任何显著变化。在开始抗高血压治疗后的短期内（1 - 4周），除卡托普利外的所有抗高血压药物均导致性功能障碍。服用阿替洛尔或三氯噻嗪的患者对列出的各项都有抱怨。服用缓释硝苯地平的患者主要抱怨射精问题。服用阿替洛尔的患者血清睾酮和促卵泡生成素水平显著降低，而雌二醇有轻度升高。在长期（1年），只有服用阿替洛尔的患者出现性功能障碍且血清睾酮水平有轻度降低。我们的研究结果表明，一线抗高血压药物对性功能有不同影响，并且就性生活质量而言，只有卡托普利可能比其他药物具有某些优势。
