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      Valsartan Appears to Improve Sexual Function in Men and Women with Hypertension: Presented at ASH(HYP)

      By Ed Susman

      NEW YORK, NY -- May 18, 2003 -- Men and women being treated with the angiotensin II receptor blocker valsartan for mild-to-moderate hypertension appear to show improvements in sexual function and desire, researchers report.

      Two European studies assessed sexual functioning in patients being treated with valsartan. In one study conducted in Bonn, Germany, doctors measured the impact of treatment in 3502 men.

      "Erectile dysfunction and other sexual dysfunction occurs often as the result of high blood pressure," said Ranier Dusing, MD, professor of internal medicine at the Medizinische Universitats-Poliklinik, Universitat Bonn, Germany "and then some of the drugs that we use to treat high blood pressure can make sexual functioning worse."

      In his study, presented May 16th at the 18th Annual Scientific Meeting of the American Society of Hypertension, Dr. Dusing said about one-third of the patients were being treated for the first time, while the other patients were switched from other drugs to valsartan.

      At the start of treatment and after 6 months of treatment, the men were given the International Index of Erectile Function (IIEF), an internationally validated 15item questionnaire. At baseline 75% of the patients were experiencing erectile dysfunction.

      When the IIEF scores were analyzed at the end of the trial, Dr. Dusing and colleagues determined that 53% of the group reported erectile dysfunction (P<0.0001).

      Sexual desire averaged 5.64 IIEF units in the total group at the start of the trial, and increased to 6.82 following treatment with valsartan (P<0.0001). When the researchers looked only at patients being treated for hypertension for the first time, they observed similar improvements.

      "The results of our study suggest that the AT1-receptor antagonist valsartan markedly improves sexual function in hypertensive males," Dr. Dusing said during his poster presentation.

      In another study, Roberto Fogari, MD, professor of internal medicine, University of Pavia, Italy, studied a group of women undergoing treatment of hypertension with valsartan. Dr. Dusing cited Dr. Fogari as a pioneer in studies on sexual dysfunction in hypertensive patients.

      Dr. Fogari suggested that valsartan and possibly other angiotensin receptor blockers act centrally in the body to produce the effect in which sexual functioning is enhanced.

      For his 16week study, Dr. Fogari enrolled 82 postmenopausal women, 51-55 years of age, with mild-to-moderate hypertension who were using hormone replacement therapy. These subjects received either 80 mg to 160 mg of valsartan or 50 mg to 100 mg of the beta-blocker atenolol.

      Blood pressure was evaluated at the end of a 4week run-in placebo period, and at the end of each treatment period. The women were asked to complete a sexual function questionnaire that comprised 10 self-evaluations of various aspects of sexual desire, orgasmic response, and coital activity. The questions were presented in the form of a visual analog scale.

      Dr. Fogari noted that while changes in sexual desire are relatively easy to measure and visualize in men, "it is a more difficult thing to determine this in women." Hence, this study used the visual analog scale and questionnaires.

      Both drugs significantly lowered BP with equal efficacy. However, the valsartantreated group had significant improvements (P<0.05) in scores for 4 of the items related to libido -- sexual attraction, sexual desire, sexual fantasies, and frequency taking initiative in sexual activity significantly improved. The women taking valsartan also showed overall improvement in their change in sexual behavior (P<0.01).

      On the other hand, women taking atenolol had either no change in sexual parameters or had significantly decreased scores for sexual desire and sexual fantasies (P<0.05).

      "These results suggest that in post-menopausal women valsartan treatment increases sexual desire and libido, while atenolol does not change sexual functioning, or reduces it. It could have some importance in the quality of life of these patients," he said.


      [Study title: Effect of Valsartan and Atenolol on Sexual Function in Hypertensive Postmenopausal Women. AbstractP-207. Effect Of The AT1-Antagonist Valsartan on Sexual Function in Hypertensive Men. Abstract P-203]



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