Disfunción sexual en la hipertensión arterial

Sexual dysfunction (SD) is understood as a persistent or recurrent alteration in any phase of the human sexual response cycle, and which consequently renders it inadequate. Most SD's have a multifactorial ethiology, and certain chronic diseases cause or are often associated with SD. Even certain drugs commonly used in the treatment of such diseases can provoke sexual alterations. Hypertension can be a cause which conditions and sometimes determines male SD, with erectile dysfunction (ED) being one of the most prevalent and well- known pathologies within the scope of SD. The prevalence of ED in the hypertensive population may be as high as 50%, it being more severe than in the general population. Its presence is probably less related to types of drugs used than to blood pressure values and coexistence of other cardiovascular risk factors. In all hypertensive men, sexual function should be evaluated both at time of diagnosis and after the introduction of new drugs since ED clearly affects quality of life, and its appearing in association with the introduction of a new antihypertensive drug may jeopardize adherence to treatment. Available evidence indicates that diuretics, betablockers, antiadrenergics of central action (methyldopa and clonidine) and vasodilators are those drugs more related to ED, and that both angiotensin receptor blockers and doxazosin can improve sexual function in hypertensive patients. In those controlled patients under treatment, but with ED, symptomatic treatment with 5-phosphodiesterase inhibitors must be evaluated.