Systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure are associated with erectile function, experts report.
The finding is based on a study of men who were participants in the larger Systolic Blood Pressure Intervention Trial (SPRINT).
SBP refers to the amount of pressure the heart exerts as it beats and is the top number of a typical blood pressure measurement. DBP, the bottom number, indicates pressure between heartbeats. Pulse pressure is the difference between SBP and DBP.
For this study, researchers collected data from 1,255 men with hypertension. The researchers used the 5-item International Index of Erectile Function (IIEF-5) to evaluate the men’s sexual activity and erectile function during the previous four weeks. They also took note of the men’s blood pressure, age, race and ethnicity, living arrangements, medications, smoking habits, and drinking habits.
The participants’ average age was 67 years. About 68% of the men had been sexually active during the previous four weeks. In that group, almost 60% had erectile dysfunction. Almost 11% took phosphodiesterase type 5 inhibitors, a common erectile dysfunction (ED) medication.
After the researchers adjusted the data for demographic, behavioral, and clinical variables, neither systolic blood pressure nor diastolic blood pressure were significantly associated with sexual activity.
However, lower SBP and higher DBP were linked to better scores on the IIEF-5, indicating better erections. Men with lower pulse pressure tended to have better erections as well.
The authors found no associations between blood pressure medications (e.g., beta-blockers and diuretics) and sexual activity or erectile function. This finding “adds to the continuing complexity of the literature regarding the role of antihypertensive medication as a possible causal factor of ED,” the authors wrote, adding that “ED is a multifactorial disorder, and many hypertensive patients are on antihypertensive polytherapy, which makes it difficult to disentangle the effects of single medications.”
Younger men and those who were more highly educated were more likely to be sexually active. However, sexual activity was less common in depressed men and men with a higher number of comorbidities.
The authors noted several limitations. The IIEF-5 assesses sexual activity over a four-week period only, and reasons for sexual inactivity were not known. It’s possible that some men were not sexually active because of ED. In addition, the men’s testosterone and other androgen levels were not measured, so it wasn’t clear whether hormones played a role with their erectile function.
The study was published online in January 2019 in the Journal of Sexual Medicine.
The Journal of Sexual Medicine
Foy, Capri G., PhD, MS, et al.
“Blood Pressure, Sexual Activity, and Erectile Function in Hypertensive Men: Baseline Findings from the Systolic Blood Pressure Intervention Trial (SPRINT)”
(Full-text. Published online: January 14, 2019)
Sheps, Sheldon G., M.D.
“What is pulse pressure? How important is pulse pressure to your overall health?”
(January 9, 2019)