Erectile dysfunction and arterial hypertension: Still looking for a scapegoat

Published:September 16, 2020DOI:
      Hypertension awareness, treatment and control have improved substantially in the past 40 years. However, control rates have plateaued in the past decade in many countries, and a substantial proportion of hypertensive patients remains uncontrolled [
      Collaboration NCDRF
      Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Collaboration NCDRF
        Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys.
        Lancet. 2019; 394: 639-651
        • Burnier M.
        • Egan B.M.
        Adherence in hypertension.
        Circ Res. 2019; 124: 1124-1140
        • Peyton C.C.
        • Colaco M.A.
        • Kovell R.C.
        • Kim J.H.
        • Terlecki R.P
        Erectile dysfunction is predictive of endothelial dysfunction in a well visit population.
        J Urol. 2016; 195: 1045-1050
        • Kumagai H.
        • Yoshikawa T.
        • Myoenzono K.
        • Kosaki K.
        • Akazawa N.
        • Asako Z.M.
        • et al.
        Sexual function is an indicator of central arterial stiffness and arterial stiffness gradient in Japanese adult men.
        J Am Heart Assoc. 2018; 7
        • Clavijo R.I.
        • Miner M.M.
        • Rajfer J
        Erectile dysfunction and essential hypertension: the same aging-related disorder?.
        Rev Urol. 2014; 16: 167-171
        • Foy C.G.
        • Newman J.C.
        • Berlowitz D.R.
        • Russell L.P.
        • Kimmel P.L.
        • Wadley V.G.
        • et al.
        Blood pressure, sexual activity, and erectile function in hypertensive men: baseline findings from the systolic blood pressure intervention trial (SPRINT).
        J Sex Med. 2019; 16: 235-247
        • Dean R.C.
        • Lue T.F.
        Physiology of penile erection and pathophysiology of erectile dysfunction.
        Urol Clin North Am. 2005; 32 (v): 379-395
        • Baumhakel M.
        • Schlimmer N.
        • Kratz M.
        • Hackett G.
        • Jackson G.
        • Bohm M
        Cardiovascular risk, drugs and erectile function–a systematic analysis.
        Int J Clin Pract. 2011; 65: 289-298
        • Silvestri A.
        • Galetta P.
        • Cerquetani E.
        • Marazzi G.
        • Patrizi R.
        • Fini M.
        • et al.
        Report of erectile dysfunction after therapy with beta-blockers is related to patient knowledge of side effects and is reversed by placebo.
        Eur Heart J. 2003; 24: 1928-1932
        • Toblli J.E.
        • Cao G.
        • Casas G.
        • Mazza O.N
        In vivo and in vitro effects of nebivolol on penile structures in hypertensive rats.
        Am J Hypertens. 2006; 19: 1226-1232
        • Baumhakel M.
        • Schlimmer N.
        • Buyukafsar K.
        • Arikan O.
        • Bohm M
        Nebivolol, but not metoprolol, improves endothelial function of the corpus cavernosum in apolipoprotein e-knockout mice.
        J Pharmacol Exp Ther. 2008; 325: 818-823
        • Deedwania P.
        • Shea J.
        • Chen W.
        • Brener L
        Effects of add-on nebivolol on blood pressure and glucose parameters in hypertensive patients with prediabetes.
        J Clin Hypertens (Greenwich). 2013; 15: 270-278
        • Manolis A.
        • Doumas M.
        • Ferri C.
        • Mancia G
        Erectile dysfunction and adherence to antihypertensive therapy: focus on beta-blockers.
        Eur J Intern Med. 2020;
        • Martinez-Salamanca J.I.
        • La Fuente J.M.
        • Cardoso J.
        • Fernandez A.
        • Cuevas P.
        • Wright H.M.
        • et al.
        Nebivolol potentiates the efficacy of PDE5 inhibitors to relax corpus cavernosum and penile arteries from diabetic patients by enhancing the NO/cGMP pathway.
        J Sex Med. 2014; 11: 1182-1192
        • Angulo J.
        • Wright H.M.
        • Cuevas P.
        • Gonzalez-Corrochano R.
        • Fernandez A.
        • Cuevas B.
        • et al.
        Nebivolol dilates human penile arteries and reverses erectile dysfunction in diabetic rats through enhancement of nitric oxide signaling.
        J Sex Med. 2010; 7: 2681-2697
        • Boydak B.
        • Nalbantgil S.
        • Fici F.
        • Nalbantgil I.
        • Zoghi M.
        • Ozerkan F.
        • et al.
        A randomised comparison of the effects of nebivolol and atenolol with and without chlorthalidone on the sexual function of hypertensive men.
        Clin Drug Investig. 2005; 25: 409-416
        • Gur O.
        • Gurkan S.
        • Yumun G.
        • Turker P
        The comparison of the effects of nebivolol and metoprolol on erectile dysfunction in the cases with coronary artery bypass surgery.
        Ann Thorac Cardiovasc Surg. 2017; 23: 91-95
        • Brixius K.
        • Middeke M.
        • Lichtenthal A.
        • Jahn E.
        • Schwinger R.H
        Nitric oxide, erectile dysfunction and beta-blocker treatment (MR NOED study): benefit of nebivolol versus metoprolol in hypertensive men.
        Clin Exp Pharmacol Physiol. 2007; 34: 327-331
        • Cordero A.
        • Bertomeu-Martinez V.
        • Mazon P.
        • Facila L.
        • Gonzalez-Juanatey J.R
        Erectile dysfunction may improve by blood pressure control in patients with high-risk hypertension.
        Postgrad Med. 2010; 122: 51-56
        • Viigimaa M.
        • Vlachopoulos C.
        • Doumas M.
        • Wolf J.
        • Imprialos K.
        • Terentes-Printzios D.
        • et al.
        Update of the position paper on arterial hypertension and erectile dysfunction.
        J Hypertens. 2020; 38: 1220-1234
        • Fogari R.
        • Zoppi A.
        • Poletti L.
        • Marasi G.
        • Mugellini A.
        • Corradi L
        Sexual activity in hypertensive men treated with valsartan or carvedilol: a crossover study.
        Am J Hypertens. 2001; 14: 27-31