Tuesday, April 6, 1999 Published at 15:42 GMT 16:42 UK
Impotence 'not a side effect' of blood pressure drugs
Impotence may not be a side effect of high blood pressure drugs
People with high blood pressure who blame their medication for impotence may be wrong, a study has found.
It indicates that most impotent men treated for high blood pressure have blocked arteries and that their problems come when their blood pressure is lowered.
However, some impotence experts argue that this still means that drugs which lower blood pressure indirectly cause erectile dysfunction.
The study by Danish urologist Dr Jesper Jensen and his team at the University of Copenhagen found that a quarter of men who received medication for high blood pressure were impotent.
This compares with a 4% rate in the general population.
The team examined 101 men who attended a blood pressure clinic.
Twenty-seven per cent said they suffered from impotence.
Most were found to have atherosclerosis or fatty deposits, which blocked the arteries to the penis.
The different drugs the men were taking appeared to have little impact on whether the men suffered impotence, suggesting the condition is not a necessary side effect of the medication.
Most of the men were on the same blood pressure medication and many were on a combination of the drugs.
Not side effects
Writing in the American Journal of Hypertension, the team said: "Our results pointed toward a mechanism related to blood pressure reduction rather than to specific drug side effects."
Sixty-two per cent of the men were on calcium channel blockers.
ACE inhibitors were taken by 55% of men.
Slightly more impotent men took ACE inhibitors and calcium channel blockers than those without problems.
But the numbers were more even for beta-blockers.
The team found that 44% of the impotent men blamed their medication for their condition, but all had atherosclerosis.
In 89% of cases, this was the cause of their impotence, the researchers said.
Older men in the group were more likely to be impotent.
The team said most men "felt great relief" at being able to discuss their problems.
It suggests that men with high blood pressure should be asked about impotence and advised about the treatments on offer.
Some impotence treatments, such as Viagra, increase blood pressure to the penis.
Ironically, Viagra was initially developed as a treatment for lowering blood pressure, but was found to be a more effective anti-impotence drug.
Professor Alan Riley, chairman of the Impotence Association, said some of the older hypertension treatments directly caused impotence.
And, despite claims to the contrary, he said many new treatments indirectly caused erectile dysfunction if high blood pressure was caused by blocked arteries.
"The drugs lower blood pressure and reduce the pressure of blood through blocked arteries.
"Before patients took the drugs, the high blood pressure would have created a head of pressure to force the blood through the arteries and cause an erection.
"Any drug that lowers blood pressure is therefore likely to give rise to impotence."
However, if high blood pressure was not a result of blocked arteries, he said, there was no reason why the newer drugs should cause impotence.
He added that he knew of men who came off their high blood pressure drugs at weekends so that they could have sex.
"It is dangerous and is not something I would recommend," he said.
Otherwise, the only way of reducing the risk of impotence linked to high blood pressure and blocked arteries is for sufferers to eat a low fat diet to lower their cholesterol.
However, this will only stop arteries from clogging up more and will not prevent already existing problems.