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Current Vascular Pharmacology

Editor-in-Chief

ISSN (Print): 1570-1611
ISSN (Online): 1875-6212

Review Article

Sexual Dysfunction, Cardiovascular Risk and Effects of Pharmacotherapy

Author(s): Konstantinos P. Imprialos*, Konstantinos Stavropoulos, Michael Doumas, Konstantinos Tziomalos, Asterios Karagiannis and Vasilios G. Athyros

Volume 16 , Issue 2 , 2018

Page: [130 - 142] Pages: 13

DOI: 10.2174/1570161115666170609101502

Price: $65

Abstract

Background: Sexual dysfunction affects millions of people with an increasing prevalence, worldwide. The pathophysiology of the disease shares several similarities with cardiovascular disease (CVD), including atherosclerosis, endothelial dysfunction, structural vascular damage and subclinical inflammation. Erectile dysfunction (ED) and female sexual dysfunction are common among patients with CVD and risk factors such as hypertension, diabetes, obesity and metabolic syndrome. Given the common pathogenesis of the diseases, ED is an independent prognostic factor of future ED events. Patients with overt ED or risk factors are usually treated with several drugs for the management of these conditions. Several of these drugs have been evaluated for their effect on sexual activity.

Results and Conclusion: Among the antihypertensive drugs, diuretics and beta-blockers seem to exert a detrimental impact on sexual function, with nebivolol being the only beta-blocker with favorable properties through an increase in nitric oxide bioavailability. In contrast, renin-angiotensin system inhibitors and calcium-channel blockers have a neutral effect on sexual activity. Hypoglycemic drugs have been less evaluated in the ED setting, with metformin, pioglitazone and liraglutide presenting favorable results. Statins on the other hand have not provided consistent results with observational studies suggesting a detrimental role in sexual activity and a few randomized studies indicating a neutral or even beneficial effect on erectile function.

Keywords: Erectile dysfunction, cardiovascular disease, vascular risk factors, antihypertensive drugs, antidiabetic drugs, statins.

Graphical Abstract

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