Sexual dysfunction in hypertensive patients treated with losartan

Background: Impaired erectile function in men is a component of the dysmeta bolic syndrome of high blood pressure as well as a sequela of antihypertens ive therapy. This prospective interventional study in men with uncontrolled hypertension (blood pressure greater than or equal to 140/90 mm Hg) used a survey instrument to assay sexual dysfunction before and after therapy wit h losartan. Methods: We evaluated the influence of a 12-week therapy with l osartan in 82 hypertensive subjects with (n = 82) and without (n = 82) a di agnosis of erectile dysfunction using a self-administered questionnaire val idated in another 60 subjects with hypertension. Results: From an initial s ample of 323 hypertensive men and women, 82 men, aged 30 to 65 years, with sexual dysfunction underwent a 12-week regimen of losartan therapy (50-100 mg/day). Losartan treatment improved sexual satisfaction from an initial 7. 3 to 58.5% (chi (2); P = 0.001). Subjects reporting a high frequency of sex ual activity improved from 40.5% initially to 62.3% after drug treatment, w hereas the number of patients with low or very low frequency of sexual acti vity decreased significantly (chi (2); P = 0.001). At the completion of the 12-week losartan regimen, only 11.8% of the treated subjects reported in i mprovement in sexual function. Improvement on quality of life was demonstra ted in 73.7% of subjects medicated with losartan, 25.5% reported no changes , and only 0.8% felt worse. In the group without sexual dysfunction, losart an had a nonsignificant effect on sexual function. Conclusions: Our data su ggest that losartan improved erectile function and both satisfaction and fr equency of sexual activity. Because side effects are one of the most influe ntial factors in the management of hypertension, an added benefit of losart an therapy may be its positive impact on quality of life.