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Knowledge About Beta-Blocker Side Effects May Lead To Erectile Dysfunction
A DGReview of :"Report of erectile dysfunction after therapy with beta-blockers is related to patient knowledge of side effects and is reversed by placebo"
European Heart Journal
11/18/2003
By Jill Taylor
Erectile dysfunction (ED) in patients taking beta-blockers may be mostly psychological, appearing more frequently in patients who know of this side effect, and is reversed in most cases by placebo, say researchers.
The complaint of ED is common in cardiovascular disease patients treated with beta-blockers. However, evidence suggests a higher rate of sexual dysfunction occurs in untreated men with cardiovascular disease compared with men of similar age, leaving the actual cause of ED unclear.
To assess whether the effect of beta-blockers on ED is related to patient knowledge of side effects, Antonello Silvestri, MD, of the Department of Medical Sciences, San Raffaele-Rome, Tosinvest Sanita, Rome, Italy, and colleagues performed a 2-phase, single cross-over study in 96 men (mean age: 52±7 years) with newly diagnosed cardiovascular disease without ED.
Forty percent of patients had hypertension and 60% had angina. The International Index of Erectile Function questionnaire was administered at study baseline, at the end of phase 1, and at the end of each treatment period of phase 2.
In the first study phase, patients received Atenolol 50 mg over 90 days. Divided into 3 groups of 32 patients, group A was blinded on the drug given, group B was informed on the drug but not side effects, and group C was informed on the drug and potential side effects.
ED incidence after 3 months was 3.1% in group A, 15.6% in group B, and 31.2% in group C (P < .01).
Patients reporting ED entered study phase 2 and were randomised to receive Sildenafil citrate 50mg or placebo. Both treatments were equally effective in reversing erectile dysfunction.
"In conclusion the occurrence of erectile dysfunction on beta-blockers is low, much lower than commonly thought," say the researchers. "The results of the present study suggest that both patient's and doctor's expectations on the risk of experiencing erectile dysfunction may influence the occurrence of this bothersome side-effect."
Eur Heart J 2003 Nov;24:21:1928-32.
"Report of erectile dysfunction after therapy with beta-blockers is related to patient knowledge of side effects and is reversed by placebo"
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