April 16, 2001 — One in four American adults has high blood
pressure, putting them at risk for heart attack and stroke. Nearly one in 10
suffers from a depressive illness. Luckily, an expanding array of prescription
drugs is available to help treat and control both conditions.
The bad news? As these drugs lower blood pressure and lift
mood, they can also mess up normal sexual functioning. So while a given
medicine might restore physical and mental health, it can also spark erectile
dysfunction, lack of interest in sex, and the potential destruction of a
relationship.
The key, say doctors who have studied drugs for hypertension
and depression, is to seek help from a physician who is up to date on what
treatments are out there and who is willing to work to find the best ones for
you . Together, you can choose one that will keep you as healthy as possible
while doing the least damage — or perhaps none at all — to your sex life.
Lowering pressure
The search for what doctors call “high-yield, low-risk”
treatment of high blood pressure has been going on for decades, writes Peter
Rudd, MD, a professor of medicine and chief of the division of general internal
medicine at Stanford (California) University Medical Center, in an editorial
published in the April 1, 2000, issue of the American Journal of
Medicine.
In recent years, the old standbys — thiazide diuretics (such
as HCTZ, Maxide) and the beta-blocker drugs (such as Lopressor) have been
joined by a tongue-twisting litany of other drug classes. You will likely hear
your doctor refer to other types of blood pressure-lowering drugs known as
alpha-blockers (Regitine, Dibenzyline), calcium antagonists (Cardizem,
Plendil), angiotensin-converting enzyme (ACE) inhibitors (Lotensin),
angiotensin II receptor antagonists (Cozaar), and direct vasodilators
(Minoxidil, Apresoline). Each works differently to lower pressure.
And despite that smorgasbord of drugs, Rudd tells WebMD, the
truth is there is much yet to be learned about the effects of blood
pressure-lowering drugs on sexual functioning.
And in women, that goes double, as the “data about female
dysfunction is scant,” he says.
Physicians do have a good idea of how some of the blood
pressure-lowering drugs affect some sexual functioning. Beta-blockers, for
instance, can reduce stimulation to the erection center.
Studies have yielded mixed results about which antihypertensive
drugs to avoid if you want to keep some romance in your life. Several have
shown, for instance that diuretics and beta-blockers are associated with more
sexual side effects, according to Rudd.
Despite that, he says, the Joint National Committee on
Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
continues to recommend those drugs first.
“Those two drugs classes have been shown to reduce heart
attack, stroke, and other major end points of high blood pressure,” Rudd
adds. But it can be a tradeoff.
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