Hypertension, anti‐hypertensive drug therapy and erectile dysfunction in diabetes

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Abstract
Aims Erectile dysfunction (ED) is common in diabetes and may be related to the high prevalence of hypertension and consequent anti‐hypertensive drug therapy in diabetic patients. The risk factors for ED were studied with particular reference to hypertension and anti‐hypertensive drugs. Methods We performed a retrospective case note analysis of 763 consecutive male patients (34% Type 1 diabetes, 65% Type 2 diabetes) attending an adult diabetic clinic to collect data on risk factors for ED. We specifically recorded the use of anti‐hypertensive drugs. Results Two hundred and ninety‐nine (39%) patients had ED. Mean age of patients with ED (61 years) was higher than those without (mean age 51 years, P < 0.001). The mean age of hypertensive patients was also significantly higher than those without. On multivariate regression analysis, age (P < 0.001), macrovascular disease (P < 0.001), sensorimotor neuropathy (P < 0.001) and HbA1c (P < 0.05) predicted ED. Neither hypertension nor any anti‐hypertensive medication independently predicted ED. Conclusion Our data suggest that ED in diabetic patients with hypertension may be related to the higher age and prevalence of macrovascular disease rather than hypertension or its treatment.