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Titolo:
LONG-TERM EFFECTS ON SEXUAL FUNCTION OF 5 ANTIHYPERTENSIVE DRUGS AND NUTRITIONAL HYGIENIC TREATMENT IN HYPERTENSIVE MEN AND WOMEN - TREATMENT OF MILD HYPERTENSION STUDY (TOMHS)
Autore:
GRIMM RH; GRANDITS GA; PRINEAS RJ; MCDONALD RH; LEWIS CE; FLACK JM; YUNIS C; SVENDSEN K; LIEBSON PR; ELMER PJ; STAMLER J;
Indirizzi:
SHAPIRO CTR EVIDENCE BASED MED,MINNESOTA MED RES FDN,914 S 8TH ST,D-5MINNEAPOLIS MN 55404 HENNEPIN CTY MED CTR,DEPT MED,DIV CLIN EPIDEMIOL MINNEAPOLIS MN 00000 UNIV MINNESOTA,SCH PUBL HLTH,DIV BIOSTAT MINNEAPOLIS MN 55455 UNIV MIAMI,SCH MED,DEPT EPIDEMIOL & PUBL HLTH MIAMI FL 00000 UNIV PITTSBURGH,DEPT MED PITTSBURGH PA 15260 UNIV ALABAMA,DEPT MED,DIV PREVENT MED BIRMINGHAM AL 35294 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,HYPERTENS CTR WINSTON SALEM NC 00000 RUSH PRESBYTERIAN ST LUKES MED CTR,DEPT MED,CARDIOL SECT CHICAGO IL 60612 RUSH PRESBYTERIAN ST LUKES MED CTR,DEPT PREVENT MED CHICAGO IL 60612 UNIV MINNESOTA,SCH PUBL HLTH,DIV EPIDEMIOL MINNEAPOLIS MN 55455 NORTHWESTERN UNIV,SCH MED,DEPT PREVENT MED CHICAGO IL 00000
Titolo Testata:
Hypertension
fascicolo: 1, volume: 29, anno: 1997,
parte:, 1
pagine: 8 - 14
SICI:
0194-911X(1997)29:1<8:LEOSFO>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
DYSFUNCTION; THERAPY; QUALITY; IMPACT; TRIAL; LIFE;
Keywords:
SEXUAL DYSFUNCTION; ANTIHYPERTENSIVE AGENTS; IMPOTENCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
21
Recensione:
Indirizzi per estratti:
Citazione:
R.H. Grimm et al., "LONG-TERM EFFECTS ON SEXUAL FUNCTION OF 5 ANTIHYPERTENSIVE DRUGS AND NUTRITIONAL HYGIENIC TREATMENT IN HYPERTENSIVE MEN AND WOMEN - TREATMENT OF MILD HYPERTENSION STUDY (TOMHS)", Hypertension, 29(1), 1997, pp. 8-14

Abstract

Problems with sexual function have been a long-standing concern in the treatment of hypertension and may influence the choice of treatment regimens and decisions to discontinue drugs. The Treatment of Mild Hypertension Study (TOMHS) provides an excellent opportunity for examination of sexual function and effects of treatment on sexual function in men and women with stage I diastolic hypertension because of the number of drug classes studied, the double-blind study design, and the long-term follow-up. TOMHS was a double-blind, randomized controlled trialof 902 hypertensive individuals (557 men, 345 women), aged 45 to 69 years, treated with placebo or one of five active drugs (acebutolol, amlodipine maleate, chlorthalidone, doxazosin maleate, or enalapril maleate). All participants received intensive lifestyle counseling regarding weight loss, dietary sodium reduction, alcohol reduction (for current drinkers), and increased physical activity. Sexual function was ascertained by physician interviews at baseline and annually during follow-up. At baseline, 14.4% of men and 4.9% of women reported problems with sexual function. In men, 12.2% had problems obtaining and/or maintaining an erection; 2.0% of women reported a problem having an orgasm. Erection problems in men at baseline were positively related to age, systolic pressure, and previous antihypertensive drug use. The incidences of erection dysfunction during follow-up in men were 9.5% and 14.7%through 24 and 48 months, respectively, and were related to type of antihypertensive therapy. Participants randomized to chlorthalidone reported a significantly higher incidence-of erection problems through 24months than participants randomized to placebo (17.1% versus 8.1%, P=.025). Incidence rates through 48 months were more similar among treatment groups than at 24 months, with nonsignificant differences betweenthe chlorthalidone and placebo groups. Incidence was lowest in the doxazosin group but was not significantly different from the placebo group. incidence for acebutolol, amlodipine, and enalapril groups was similar to that in the placebo group. In many cases, erection dysfunctiondid not require withdrawal of medication. Disappearance of erection problems among men with problems at baseline was common in all groups but greatest in the doxazosin group. Incidence of reported sexual problems in women was low in all treatment groups. In conclusion, long-termincidence of erection problems in treated hypertensive men is relatively low but is higher with chlorthalidone treatment. Effects of erection dysfunction with chlorthalidone appear relatively early and are often tolerable, and new occurrences after 2 years are unlikely. The rateof reported sexual problems in hypertensive women is low and does notappear to differ by type of drug. Similar incidence rates of erectiondysfunction in placebo and most active drug groups caution against routine attribution of erection problems to antihypertensive medication.

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Documento generato il 25/11/20 alle ore 07:13:38