Erectile Function in Cardiovascular Disease and Hypertension: the Role of Nebivolol

Athanasios Manolis,Michael Doumas

doi:10.4172/2167-1095.1000226

Athanasios Manolis, Michael Doumas

Open Access

https://doi.org/10.4172/2167-1095.1000226

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Abstract

Beta blockers are used for the management of arterial hypertension and are gold standard treatment for coronary artery disease and heart failure, medical conditions that affect large numbers of older patients and are associated with very high morbidity and mortality rates. Lifelong therapy in primary and secondary prevention (without and with established cardiovascular disease, respectively) is limited by low adherence to drugs which is accompanied by increased mortality. Drug adverse events and impaired quality of life are among the main causes of poor adherence to therapy. Erectile dysfunction is the ‘prima ballerina’ of drug-induced life quality impairment. Beta blockers exert detrimental effects on erectile function. In contrast, nebivolol (a third generation beta blocker with vasodilating properties and proven efficacy in patients with hypertension and heart failure) does not share the unfavourable effects of other beta blockers on erectile function due to increased nitric oxide bioavailability. Therefore, Nebivolol represents an attractive option for patients with hypertension, heart failure, and other related diseases who need to be treated with beta blockers.

Highlights

Cardiovascular disease is the leading cause of mortality worldwide
It is of no surprise that erectile dysfunction is highly prevalent in patients with cardiovascular risk factors or overt cardiovascular disease, with rates ranging from 40% to 90% that are significantly greater than in individuals free of cardiovascular disease [4,5,6,7,8]
Nebivolol unlike traditional beta blockers does not exert detrimental effects on glycose homeostasis [17] even in combination with diuretics [18], is effective in patients with endothelial dysfunction [19], has a superior effect on central aortic pressure and left ventricular wall thickness compared to other beta blockers [20,21,22], is more effective in patients

Summary

Introduction

Cardiovascular disease is the leading cause of mortality worldwide. Arterial hypertension is a major cardiovascular risk factor, affects almost one third of the adult population and is associated with approximately 7.6 million deaths annually [1]. Data from experimental, observational, and clinical studies point towards a detrimental effect of beta blockers on erectile function with the exception of nebivolol. Nebivolol in hypertensive patients does not exert a negative effect in clinical studies but seems to exert a positive effect on erectile function through enhanced nitric oxide bioavailability.

Results

Conclusion