Impact of Anti-hypertensive Therapy in the Sexual Health of Men and Women: An Analysis From the SPRINT Trial

BACKGROUND Pharmacologic anti-hypertensive (HT) treatment reduces cardiovascular risk. However, many patients are nonadherent due to perceived or real concern about sexual-related side effects. METHODS In a subset of the SPRINT (a randomized trial of intensive vs. standard blood-pressure control) trial, we sought to investigate the impact of anti-HT treatment on sexual activities of men and women over time, and whether this impact varied with a more or less intensive anti-HT therapy. Random-effects models for panel/longitudinal data. RESULTS Among the 1,268 men and 613 women included in this substudy, 862 (68%) men and 178 (29%) women declared to be engaged in sexual activity of any kind. Compared with women and men not engaged in sexual activity, those engaged were younger (64 vs. 69 years for women and 65 vs. 75 years for men). Women had an overall low satisfaction with their sexual life but their sexual health was not affected by anti-HT therapy over time nor modified by an intensive treatment. Men's erections were slightly deteriorated over time (-0.1 to -0.2 points on a scale of 1 (worse) to 5 (best); P < 0.05), but were not aggravated by intensive anti-HT therapy (P > 0.05 for all). CONCLUSIONS Self-declared women's sexual health was not affected by an intensive anti-HT therapy. Men reported a slight deterioration in the quality of their erections, irrespective of standard or intensive therapy. These findings may help reassuring patients about the sexual safety of intensive anti-HT therapy, therefore, potentially improving adherence to intensive therapy strategy.