Hipertensión arterial, medicación antihipertensiva y disfunción eréctil: una perspectiva basada en la evidencia

(1) High blood pressure multiplies the risk of ED by approximately 1.5 to 3-fold; (2) the largest difference found in the prevalence of ED was between normotensive and hypertensive men, regardless of whether they were receiving antihypertensive medication or not; smaller differences were found between the 2 subgroups of hypertensive subjects; (3) there is no clear association between any class of antihypertensive medication and the incidence of ED; some drug types (notably the angiotensin II receptor antagonists) might have protective effects against ED; (4) ED and high blood pressure share some pathogenic mechanisms, including endothelial dysfunction and/or arterial and cavernosal smooth muscle abnormalities, (5) PDE5 inhibitors are safe and effective in hypertensive patients and have no significant interactions with most antihypertensive drugs. However, caution should be exercised in their use with β1-blockers, which is contraindicated in some of them.