PP.26.07] IMPACT OF VALSARTAN AND COMBINATION OF VALSARTAN AND HYDROCHLOROTHIAZIDE ON ERECTILE DYSFUNCTION IN PATIENTS WITH MILD TO MODERATE HYPERTENSION

Abstract

Objective: Erectile dysfunction is recognised quality of life disorder frequently occurring in hypertensive patients. It can be caused by high blood pressure per se or due to antihypertensive treatment. Diuretics and -blockers (except nebivolol) are the drugs most commonly linked to erectile dysfunction. ACE inhibitors and calcium antagonists seem to exert neutral effects, while ARBs seem to be associated with beneficial effects on erectile function. The aim of our study was to assess the effect of treatment with valsartan and valsartan-HCTZ on erectile function. Design and method: We assessed erectile dysfunction in 98 patients, aged 40 – 79 years, with mild to moderate hypertension, participating in international, multicentre, open labelled trial – VICTORY (sponsored by KRKA, d.d.) using the questionnaire IIEF-5, before and after 16 week of treatment with valsartan or valsartan-HCTZ. The treatment was initiated with 80 mg of valsartan daily. After four weeks of treatment the dose was increased to 160 mg valsartan daily in patients who did not achieve goal blood pressure. If target blood pressure was not achieved after consequent 4 weeks the dose of valsartan was further increased to 320 mg daily or fixed combination of valsartan-HCTZ 160/12.5 mg daily was implemented. At next visit, after additional 4 weeks, in patients who did not achieve goal blood pressure, the dose of fixed combination was increased to 320/12.5 mg of valsartan-HCTZ daily. Results: At the end of the trial, in 90.6% of patients, the goal blood pressure, according to 2013 ESH/ESC Guidelines for the management of arterial hypertension, was achieved. The slight statistically significant increase in mean IIEF-5 score after 16 weeks of treatment was observed in patients on monotherapy with valsartan and in patients on combination therapy with valsartan-HCTZ which was introduced on visit 3 or visit 4 (from 23.5 7.7 to 24.1 8.1, and from 23.8 5.0 to 24.2 6.7, respectively). Conclusions: Goal blood pressure was achieved in 90.6% of patients. Treatment with valsartan as well as adding low dose of HCTZ to valsartan did not lead to deterioration of erectile function in patients with mild to moderate hypertension.