Erectile Dysfunction in Arterial Hypertension

Erectile dysfunction, the inability to attain, respectively maintain a penile erection sufficient for sexual intercourse, is a frequent finding in the general population. It is a multi-factorial syndrome that may arise from chronic disease such as arterial hypertension, but also from psychosocial problems, as a side effect of certain medications, alcohol or drugs, or from impaired nerve function. Erectile dysfunction is associated with an increased risk of cardiovascular morbidity and mortality. The approach to the patient should include a thorough cardiovascular, endocrine, neurological, urological and psychological evaluation. In patients with arterial hypertension, diuretics and beta-blockers may impair erectile function while beneficial effects of angiotensin receptor blockers, ACE inhibitors, and nebivolol have been demonstrated. PDE-5-inhibitors may be considered in stable patients with controlled arterial hypertension but refractory erectile dysfunction.