Highlights
- •Both hypertension itself and βeta-blocker drugs used for hypertension treatment can cause ED.
- •The anti-hypertensive effects of Nebivolol and Metoprolol are similar.
- •Nebivolol, unlike other β-blockers, may not cause impotence since it increases NO release which is the main mediator of erection.
- •Nebivolol may be advantageous in terms of preserving sexual functions in eligible hypertensive male patients.
Abstract
Introduction
Both hypertension and β-blocker drugs used for treating hypertension (HT) can cause
erectile dysfunction (ED). Nebivolol, unlike other β-blockers, may not cause impotence
since it increases the release of Nitric Oxide (NO), which is the main mediator of
erection. This study investigated the effect of Nebivolol and Metoprolol on erectile
functions in hypertensive men.
Materials and methods
Married men whose blood pressure were >140/90 mmHg were included in the study. All
patients were assessed for ED, and the cause of ED was then investigated. Nebivolol
or Metoprolol was started for one month in all patients. After one-month drugless
period, the β-blockers were switched. Blood pressures, pulses and sexual function
tests were evaluated, and plasma NO levels were measured at the end of the treatments
and during the drugless period.
Results
There was no difference in antihypertensive efficacy between the two drugs (p = 0.828;0.194 for systolic and diastolic BP). Metoprolol caused a significant decrease
in IIEF-5 score, whereas Nebivolol did not cause a decrease in IIEF-5 score on patients
with psychogenic, arteriogenic, and venous failure related ED (respectively, p<0.001,0.004,0.005 for Metoprolol; p = 0.201,0.598,0.088 for Nebivolol). In the non-ED group, both drugs decreased the
IIEF-5 score, but the decrease for Metoprolol (p = 0.001) was more than that for Nebivolol (p = 0.012). Plasma NO levels did not change with Metoprolol (p = 0.268) but increased with Nebivolol (p<0.001). There was a positive correlation between plasma NO values and IIEF-5 score
used for the assessment of sexual functions (r = 0.284, p = 0.026).
Conclusion
Nebivolol may be advantageous in terms of preserving sexual functions because of increasing
NO in eligible hypertensive male patients.
Keywords
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Article info
Publication history
Published online: June 23, 2022
Accepted:
June 17,
2022
Received in revised form:
April 10,
2022
Received:
January 20,
2022
Identification
Copyright
© 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
