Vella Agnese, Dobretz Kevin, Valerio Massimo, Guillermet Elise, Ehret Georg
Cardiologie préventive, Service de cardiologie, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14.
Service d'urologie, Département de chirurgie, Hôpitaux universitaires de Genève, 1211 Genève 14.
Rev Med Suisse. 2024 Sep 11;20(886):1613-1616. doi: 10.53738/REVMED.2024.20.886.1613.
Hypertensive patients are frequently affected by erectile dysfunction (20-25%). This is often a manifestation of atherosclerosis, a systemic disease that itself requires management. Dietary measures and physical activity are beneficial for these patients. Regarding pharmacological options, these include modifying the antihypertensive treatment or using a phosphodiesterase type 5 inhibitor (PDE5 inhibitor) in males. The preferred antihypertensive treatments are angiotensin 2 receptor antagonists, ACE inhibitors, calcium channel blockers, and if necessary, a vasodilating beta-blocker (nébivolol). Thiazide and thiazide-like diuretics (with the exception of indapamide), traditional beta-blockers, and central antihypertensive agents should be avoided.
高血压患者常受勃起功能障碍影响(20%-25%)。这通常是动脉粥样硬化的一种表现,动脉粥样硬化是一种本身就需要治疗的全身性疾病。饮食措施和体育活动对这些患者有益。在药物治疗方面,对于男性患者,可调整抗高血压治疗方案或使用5型磷酸二酯酶抑制剂(PDE5抑制剂)。首选的抗高血压治疗药物是血管紧张素2受体拮抗剂、血管紧张素转换酶抑制剂、钙通道阻滞剂,必要时可使用血管舒张性β受体阻滞剂(奈必洛尔)。应避免使用噻嗪类和噻嗪样利尿剂(吲达帕胺除外)、传统β受体阻滞剂和中枢性抗高血压药物。