Université de Lorraine, Centre d'Investigations Cliniques Plurithématique Inserm 1433, Nancy, France.
CHRU de Nancy, Inserm U1116, Nancy, France.
Am J Hypertens. 2021 Aug 9;34(7):760-772. doi: 10.1093/ajh/hpab035.
Pharmacologic anti-hypertensive (HT) treatment reduces cardiovascular risk. However, many patients are nonadherent due to perceived or real concern about sexual-related side effects.
In a subset of the SPRINT (a randomized trial of intensive vs. standard blood-pressure control) trial, we sought to investigate the impact of anti-HT treatment on sexual activities of men and women over time, and whether this impact varied with a more or less intensive anti-HT therapy. Random-effects models for panel/longitudinal data.
Among the 1,268 men and 613 women included in this substudy, 862 (68%) men and 178 (29%) women declared to be engaged in sexual activity of any kind. Compared with women and men not engaged in sexual activity, those engaged were younger (64 vs. 69 years for women and 65 vs. 75 years for men). Women had an overall low satisfaction with their sexual life but their sexual health was not affected by anti-HT therapy over time nor modified by an intensive treatment. Men's erections were slightly deteriorated over time (-0.1 to -0.2 points on a scale of 1 (worse) to 5 (best); P < 0.05), but were not aggravated by intensive anti-HT therapy (P > 0.05 for all).
Self-declared women's sexual health was not affected by an intensive anti-HT therapy. Men reported a slight deterioration in the quality of their erections, irrespective of standard or intensive therapy. These findings may help reassuring patients about the sexual safety of intensive anti-HT therapy, therefore, potentially improving adherence to intensive therapy strategy.
药物降压(HT)治疗可降低心血管风险。然而,许多患者因担心或实际担心与性相关的副作用而不遵医嘱。
在 SPRINT 试验(强化与标准血压控制的随机试验)的一个亚组中,我们试图研究抗 HT 治疗对男性和女性随时间推移的性活动的影响,以及这种影响是否随更强化或不太强化的抗 HT 治疗而变化。面板/纵向数据的随机效应模型。
在这项亚研究中,纳入了 1268 名男性和 613 名女性,其中 862 名(68%)男性和 178 名(29%)女性表示从事过任何形式的性行为。与不参与性活动的女性和男性相比,参与性活动的女性年龄较小(女性为 64 岁,男性为 65 岁)。女性对性生活的总体满意度较低,但随着时间的推移,抗 HT 治疗并未影响她们的性生活健康,也不会因强化治疗而改变。男性的勃起功能随着时间的推移略有恶化(1 分(最差)至 5 分(最好)的评分下降 0.1 至 0.2 分;P < 0.05),但强化抗 HT 治疗并未加重(所有 P > 0.05)。
自我报告的女性性健康不受强化抗 HT 治疗的影响。男性报告勃起质量略有恶化,无论接受标准治疗还是强化治疗。这些发现可能有助于让患者对强化抗 HT 治疗的安全性放心,从而提高对强化治疗策略的依从性。