Abstract P101: The Association of Hypertension and Antihypertension Medication Use with Sexual Health: A Study from the National Social Health and Aging Project (NSHAP)

Abstract

Background Hypertension (HTN) and its treatment are commonly associated with sexual problems; yet, data are discordant in men and lacking in women. We investigated the association of HTN and its treatment with sexual health in older adults, and whether the association varied by gender and medication class. Methods Data are from the NSHAP, a nationally-representative observational study of men and women aged 57-85 yrs. Adults were stratified by HTN status: No HTN; HTN-Treated; and HTN-Untreated. HTN was defined by self-report or a mean blood pressure ≥140/90mmHg. HTN-Treated adults reported taking ≥1 of the following medications: diuretics, beta-blockers, calcium-channel blocker, ACE inhibitors or angiotensin receptor blockers, and alpha blockers. We report the prevalence of partnered sexual activity and problems by HTN status. Models testing the association of medication class were examined, stratified by gender, and adjusted for other antihypertensive medication classes (Model 1), and Model 1 plus age, partner status, insurance, diabetes, heart disease, smoking, and functional status (Model 2). Results Comparing HTN-treated to HTN-Untreated and No HTN, the prevalence of sexual activity in men was 60.7% v. 74.3% v. 71.5% (p=.002) and in women 35.4% v. 38.3% v. 58.0% (p<.001). The prevalence of sexual problems in men was 69.3% v. 53.8% v. 51.4% (p=.005) and in women 73.9% v. 66.7% v. 71.7% (p=.367). Most commonly cited were erectile problems (41%) in men with HTN. Diuretics (unadjusted: OR=0.68, p 0.02; Model 1: OR=0.69, p=.03; Model 2: OR=0.72, p=.17) and beta blockers (unadjusted: OR=0.69, p 0.02; Model 1: OR=0.67, p=.03; Model 2: OR=0.79, p=.33) were associated with sexual inactivity in men with treated HTN; diuretics, only, were associated with sexual inactivity in women (unadjusted: OR=0.81, p 0.25; Model 1: OR=0.76, p=.14; Model 2: OR=0.58, p=.02). There were no significant associations with sexual problems. Discussion HTN and its treatment are associated with sexual inactivity; diuretics more than other medication classes. In men but not women, treatment is also associated with sexual problems but medication class has no effect. More research investigating gender-specific mechanisms linking HTN and its treatment with sexual health is needed.