The Link Between Erectile Dysfunction and Hypertention

High blood pressure (HBP) affects people of all ages, race and walks of life. This medical     condition can put stress on the heart, lungs, brain, kidneys, and blood vessels and eventually, it can damage these organs and tissues. The medical term for high bloodpressure

is “hypertension”. Hypertension is a serious condition that, according to theAmerican Heart Association, affects 50 million Americans—or one in four adults in America.

      Hypertension is also one of the most closely linked conditions to erectile dysfunction or ED. An estimated 152 million men worldwide suffer from ED. It is a condition where a man cannot achieve or maintain a sufficiently rigid erection to have a satisfactory intercourse. This condition is one of the most common sexual problems for men and the number of men suffering from ED increases with age. ED has many causes, most of which are treatable, and is not an inevitable result of aging. Studies have revealed that approximately 80% of all ED cases arise from physical (organic) disorders, although psychological disorders can also lead to ED. Vascular diseases, diabetes, chronic medical conditions and hypertension are examples of the physical causes of ED.

Commonalities between high blood pressure and ED

There is a strong association between hypertension and ED. Findings have shown that around 17% of men with untreated HBP and 24% of men with HBP managed by drugs have ED.

     The common underlying factor between HBP and ED is the constriction of blood vessels. HBP makes the heart work harder and puts strain on the blood vessels. When the blood vessels become hard and narrow, the arteries are less able to deliver blood to the body’s organs, including the penis. Without sufficient oxygen and nutrients, the tissues of organs like the penis can either become impaired and less able to function or do not receive enough blood to achieve and/or maintain an erection. It is not clearly known how hypertension causes ED; however, patients with hypertension have been found to have low production of nitric oxide by the arteries of the body, including the arteries in the penis. Scientists now suspect that the decreased levels of nitric oxide in hypertensive patients may contribute to ED. Most men with high blood pressure can be safely and effectively treated for ED.

Diagnosis

Possible symptoms of high blood pressure vary from person to person. Symptoms such as headaches, heart palpitations, shortness of breath after exertion, blurred vision and fatigue could signal hypertension. HBP however can only be detected with precise and frequent measurements of a person’s blood pressure. It is diagnosed during a visit

to the doctor with two or more readings over 140/90.

     ED however can be diagnosed with a physical and a laboratory exam. The doctor will ask the patient questions about physical and mental history, in order to help pinpoint the cause. The doctor may diagnose a patient’s ED to be related to HBP, or to another medical condition. Besides HBP, other heart and blood supply (or “circulatory”) conditions which lead to ED include atherosclerosis (hardening of the arteries) and vascular disease.

Treatment

ED causes significant emotional stress, and can lead to loss of self-confidence and depression in men. These days, many effective and well-tolerated options are available for treating ED. Today there are three oral drugs approved by the FDA to treat ED: Cialis, Levitra, and Viagra. These drugs are unique because they only work when a man is sexually stimulated.  The brain responds to sexual stimulation by sending out nerve signals that releases nitric oxide, which relaxes muscles in the penis to let more blood flow in and compresses the veins that normally carry blood away from the penis. This results in an erection ofthe penis.

     The most popular and widely used treatments for ED are oral medications that became available only in 1999. The first oral drug available in Singapore was sildenafil. However, in 2003, two new drugs, Cialis (tadalafil) and vardenafil were made available to ED sufferers. All three drugs have more than 80% efficacy, good tolerability and safety profiles. However, sildenafil and vardenafil work for four to six hours whereas Cialis (tadalafil) works for 36 hours. This is an advantage for Cialis as it reduces performance anxiety in men and gives them a broader window of efficacy. In addition, both sildenafil and vardenafil should be taken before food as food reduces the efficacy of the drugswhereas the efficacy of Cialis is not affected by food. 

     Apart from prescription pills, penile implants, vacuum devices, surgery and psychotherapy are several other ED treatment options. Men should also adopt healthy lifestyle habits such as eating a less salty diet that lowers blood pressure, avoid excessive intake of alcohol, quit smoking, exercise daily and maintain their ideal body weight.

     Because ED has such a close connection with HBP it is important for men to overcome their hesitation or embarrassment about ED and seea doctor •