Abstract

This study was designed to investigate the impact of representative antihypertensive drugs of 5 classes on the sexual function in male spontaneously hypertensive rats (SHR) at doses that achieved similar blood pressure (BP) reduction. The experiment was performed in 6 groups of male SHR. The dose are 20 μg/kg/day for clonidine, 3 mg/kg/day for enalapril, 20 mg/kg/day for atenolol, 2 mg/kg/day for amlodipine, and 10 mg/kg/day for dihydrochlorothiazide. SHR were treated for 3 months, and then the penile erection and sexual behavior were detected. After BP recording, SHR were killed to evaluate the organ-damage, weight of accessory sex organs and levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone in serum. Five drugs had the similar efficacy on BP reduction. All drugs except of enalapril, significantly prolonged the mount latency, and decreased the mount frequency (P<0.05). Clonidine also reduced the conception rate (45% vs. 80% in control group, P<0.05). Amlodipine and dihydrochlorothiazide significantly increased the testosterone level (0.79±0.30, 0.80±0.34 vs. 0.49±0.20 in control group, unit: ng/dl, P<0.05). Enalapril, atenolol and amlodipine also significantly decreased the BP variability (systolic, 8.2±2.5, 7.6±1.8, 8.9±2.0 vs. 12.2±3.8 in control group, unit: mm Hg). All these drugs significantly decreased the organ-damage (P<0.05). In conclusion, long-term treatment with 5 common antihypertensive drugs possessed obvious organ protection in SHR. Clonidine, atenolol, amlodipine and dihydrochlorothiazide, but not enalapril, impair sexual function.

Highlights

  • Decreased sexual activity and function is very common in patients with cardiovascular disease [1, 2]

  • Some data showed that angiotensin II antagonists might be beneficial for erectile function and sexual activity [5, 6], there are no good direct data to recommend a specific class of cardiovascular drug to improve sexual function in patients with cardiovascular disease [1]

  • Recent studies and reviews have not found clear relationships between contemporary antihypertensive drugs and sexual activity [20,21,22,23]; many reports show that numerous classes of cardiovascular drugs have been implicated in causing erectile dysfunction [7, 8, 24]

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Summary

Introduction

Decreased sexual activity and function is very common in patients with cardiovascular disease [1, 2]. A clinical study reports that BP control by β-blockers is associated with the lower prevalence of sexual dysfunction, independent of age, cardiovascular disease, and medical treatments and that beneficial effect of BP control is greater in older patients.. The side effect of antihypertensive hypertensive drugs might destroy the benefit of BP control on sexual function. Both BP control and the side effect of different antihypertensive drugs should be considered to improve the patients’ adherence

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