High Blood Pressure and ED: When Medicine Is a Problem

To treat erectile dysfunction (ED), you have to lower your blood pressure first. Some people are able to do that through lifestyle changes alone. Others need help from prescribed blood pressure medication.

A problem for many men, however, is that some types of blood pressure medicines can actually cause erectile dysfunction. That may make it difficult to stay on your medication, especially if your high blood pressure never caused any symptoms before. An estimated 70% of men who have side effects from blood pressure medicine stop taking it.

Many drugs used to treat high blood pressure have been linked to erectile dysfunction. But some are much less likely than others to cause problems. Certain of the blood pressures drugs may even improve erectile dysfunction for some men.

It's known that diuretics (or water pills, like hydrochlorothiazide) and beta-blockers (like Atenolol) can cause erection problems. These are also the first drugs that a doctor is likely to prescribe if you are not able to lower your blood pressure through diet and exercise.

If you're taking a diuretic, you should stay on your medicine until your blood pressure is under control. If your erection problem persists, or your blood pressure goes back up, then your doctor might switch you to a drug that's less likely to cause erectile dysfunction. Or, a combination of medications might work better to control your blood pressure and reduce the risk of erectile dysfunction.

If you take a beta blocker you may also want to ask your doctor if it might cause erectile dysfunction. You might be better off on a medication less likely to cause a problem.

Erection-Friendly High Blood Pressure Drugs
Some families of high blood pressure drugs rarely cause erectile dysfunction as a side effect:

ACE inhibitors
Alpha-blockers
Calcium channel blockers
ARBs
ACE (angiotensin converting enzyme) inhibitors -- such as Lotensin, Capoten, Zestril, Prinivil, etc. -- widen blood vessels and increase blood flow. Erectile dysfunction is rarely a side effect, occurring in less than 1% of patients. There are several different medications in the category. This seems to be true of all of them.

There are also medications known as calcium channel blockers, such as Diltiazem, Verapamil, or Amlodipine. As a group, they rarely cause erectile dysfunction. But erection problems may be less common with some individual drugs within that group than with others. Your doctor can tell you which.

In general, alpha-blockers do not often cause erection problems either. In one study published in the journal Hypertension in 1997, a small number of men actually had a 100% improvement in their erectile dysfunction after two years on the alpha-blocker Cardura.

Drugs known as ARBs (angiotensin II receptor blockers, like Losarten) are not only unlikely to cause erection problems, but they may actually improve sexual function in men with high blood pressure.

A 2001 study published in the American Journal of the Medical Sciences looked at the drug Cozaar, an ARB. At first, just 7% of men and women in the study said they felt sexually satisfied overall. After 12 weeks of Cozaar, about 58% said they were sexually satisfied. The percentage of men who reported having erectile dysfunction dropped from 75% to 12%.

Another study compared the drug Diovan, an ARB, with Coreg, a beta-blocker. The study, published in the American Journal of Hypertension in 2001, compared the effect of the two drugs on blood pressure and frequency of sexual intercourse.

The drugs controlled blood pressure equally well. But people who took the ARB reported having sex more often during the 16 weeks of treatment. They said they had sex about eight times a month before, and 10 times a month after. People taking the beta-blocker had sex much less often: eight times a month before, and four times a month after.

Steps to Take If Your Medicine Causes Erection Problems
Tell your doctor if you think your blood pressure medicine may be causing problems with your erections.

If it is your medication, and not just your high blood pressure, switching to another prescription may solve the problem. Never stop taking your medicine without your doctor's OK.

But high blood pressure itself still could be to blame for your erectile dysfunction. In that case, ask about trying an erectile dysfunction drug like Viagra, Cialis, or Levitra.

You should only take these drugs once your blood pressure is under control. They are not safe for men with untreated high blood pressure. They are also not safe for men taking alpha-blockers, or men taking nitrate drugs for heart disease.

This article can be found at: WebMD Medical Reference


SOURCES: American Urological Association, "AUA Guideline on the Management of Erectile Dysfunction: Diagnosis and Treatment Recommendations." Barksdale, J. Pharmacotherapy, May 1999; vol 19: pp 573-581. Ferrario, C. Journal of Clinical Hypertension, November/December 2002; vol 4: pp 424-432. Fogari, R. American Journal of Hypertension, January 2001; vol. 14: pp 27-31. Grimm, R. Hypertension, January 1997; vol 29: pp 8-14. Llisteri, J. American Journal of the Medical Sciences, May 2001; vol. 321: pp 336-341. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Hypertension: Treatment With ACE Inhibitors."





DISCLAIMER: The information and opinions expressed on this blog are not an endorsement or recommendation for any medical treatment, product or course of action by One For The Aging. For medical, legal or other advice, please consult appropriate professionals of your choice.




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