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Certain cholesterol, BP drugs do not impact erectile function
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Men who took rosuvastatin and/or candesartan with hydrochlorothiazide were unlikely to experience adverse events related to erectile function, according to findings recently published in the Canadian Journal of Cardiology.
“Previous research suggests that cardiovascular risk factors such as high blood pressure and cholesterol increase the risk of [erectile dysfunction], but there has been little research examining whether modifying these risk factors can impact its development,” Philip Joseph, MD, assistant professor of medicine at McMaster University in Ontario, Canada, said in a press release.
Researchers performed a substudy of 2,153 men (mean age, 61.5 years) with at least one CVD risk factor who were previously part of the Heart Outcomes Prevention Evaluation-3 randomized controlled trial. Participants had a mean International Index of Erectile Function score of 23 (standard deviation = 5.6) at baseline. Researchers looked at results after a mean of 5.8 years in patients receiving 10 mg of rosuvastatin per day vs. placebo, 12.5 mg of candesartan with hydrochlorothiazide vs. placebo, or both treatments vs. double placebo.
Joseph and colleagues found that when compared to placebo, the least square mean change in International Index of Erectile Function score in patients taking rosuvastatin did not change (standard error = –1.4 vs. –1.5, P = .74). Results were also insignificant in patients who took candesartan with hydrochlorothiazide (standard error = –1.6 vs. –1.3; P = .1), and those who took both medications (standard error = –1.7 vs. –1.4; P = .35).
Researchers added that patients did see significant reductions in their LDL when using rosuvastatin, as well as their BP when using candesartan with hydrochlorothiazide, and that differences in erectile function were not directly linked with differences in either BP or LDL levels while the patients were studied.
“Men who develop [erectile dysfunction] while on such medications commonly attribute their symptoms to the medications,” Joseph said in the release. Our findings suggest that these two medications do not negatively impact erectile function, which should be reassuring to men who are taking them.”
In a related editorial, G.B. John Mancini, MD, FRCPC, FACC, of the division of cardiology at the University of British Columbia, Vancouver, Canada, wrote that Joseph and colleagues’ study “is critically important and a unique contribution to this area of research,” even with its limitations of small sample size; no analysis of interactions of rosuvastatin and candesartan with hydrochlorothiazide with those taking [erectile dysfunction] therapies; and no prior International Index of Erectile Function data for comparison with the study’s results.
“Although there is no ‘free ride’ (ie, it is disappointing that new-onset [erectile dysfunction] or the rate of decline of [erectile dysfunction] were not altered as a result of the known benefits on vascular endothelial function), it is still important to emphasize the landmark significance and importance of effective primary prevention through modification of lipid- and blood pressure-related risk with safe medications,” he wrote.
Patients concerned about erectile dysfunction and not using nitrates should be more thoroughly evaluated and, when clinically relevant, advised about phosphodiesterase 5 inhibitors, Mancini added.
“The current report provides strong motivation for cardiologists to develop confidence and competence in the overlap between quality of life as reflected by male sexual health and reduction of cardiovascular risk,” he concluded. – by Janel Miller
Disclosure: Neither Joseph nor Mancini report any relevant financial disclosures. Please see the study for a list of the other authors’ relevant financial disclosures.