Prof. Dr. Martin Middeke
Nitric Oxide Erectile Dysfunction and Beta-Blocker Treatment
1. Hypertensive men treated with beta-blockers frequently complain of erectile dysfunction. The present study investigated the effects of two b1-adrenoceptor-selective antagonists, namely nebivolol and metoprolol, on erectile function in hypertensive men.
2. Maleout-patients (agerange40–55years) with newly diagnosed or existing stage 1 essential hypertension (mean seated systolic blood pressure 140 –159 mmHg; diastolic blood pressure 90 – 99 mmHg) were enrolled in the study. All patients lived in a stable, heterosexual partnership and had no history of sexual dysfunction. After a 2 eek placebo run-in period, patients were randomized double-blind to either Treatment group A (comprising nebivolol 5 mg once daily for 12 weeks, followed by placebo for 2 weeks and then metoprolol succinate 95 mg once daily for 12 weeks) or Treatment group B (comprising metoprolol succinate 95 mg for 12 weeks, placebo for 2 weeks and then nebivolol 5 mg for 12 weeks). An international index of erectile function (IIEF) questionnaire and a diary documented patients’ sexual function and activity.
3. Nebivolol and metoprolol lowered blood pressure to a similar extent. Metoprolol, but not nebivolol, significantly decreased the IIEF erectile function subscore by 0.92 in the first 8 weeks after onset of beta-blocker treatment. In contrast with metoprolol, nebivolol improved secondary sexual activity scores and other IIEF subscores.
4. Despite similar antihypertensive efficacy of the cardioselective b1-adrenoceptor antagonists nebivolol and metoprolol, nebivolol may offer additional benefits by avoiding erectile dysfunction in male hypertensive patients on long-term b-adrenoceptor antagonist therapy.
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