From the Guidelines
For individuals with hypertension (HTN) experiencing erectile dysfunction (ED), the most effective treatment approach is to use FDA-approved oral phosphodiesterase type 5 inhibitors (PDE5i), such as sildenafil, tadalafil, vardenafil, and avanafil, as they have been shown to be safe and effective in this population 1.
Key Considerations
- PDE5i medications have been extensively studied, with a large body of evidence supporting their efficacy and safety in men with ED, including those with hypertension 1.
- The choice of PDE5i should be based on individual patient preferences, including ease of use, cost of medication, and adverse effects profile 1.
- Lifestyle changes, such as weight management, regular exercise, limiting alcohol, quitting smoking, and stress reduction, are also essential in managing both ED and hypertension 1.
Natural Remedies and OTC Options
- While some natural remedies and over-the-counter options, such as L-arginine supplements and Panax ginseng, may have modest benefits for ED, their effectiveness and safety in individuals with hypertension are not well established 1.
- Vitamin D supplementation may be beneficial for individuals with deficiency, but its impact on ED is unclear 1.
- DHEA supplements may be beneficial for some men, but caution is necessary due to potential interactions with blood pressure medications 1.
Important Warnings
- Yohimbe should be avoided due to its potential to raise blood pressure dangerously 1.
- Men with ED should consult their doctor before trying any remedy, as ED can be a side effect of some blood pressure medications, and their physician may need to adjust their current treatment or prescribe ED medications that are safe with their hypertension condition 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Natural Remedies and OTC Medications for ED in Hypertension
- There are no natural remedies mentioned in the provided studies that can help with erectile dysfunction (ED) in someone with hypertension (HTN).
- However, several studies discuss the use of phosphodiesterase-5 (PDE5) inhibitors, such as sildenafil, vardenafil, and tadalafil, as effective treatments for ED in patients with hypertension 2, 3, 4, 5.
PDE5 Inhibitors and Their Effects on Blood Pressure
- PDE5 inhibitors have been shown to reduce blood pressure in healthy patients, with declines in blood pressure ranging from -1.6/-0.8 mm Hg to -7.5/-8 mm Hg 2.
- The additive effect of PDE5 inhibitors with one or multiple antihypertensive drugs is modest, but caution should be exercised when using these medications in combination, especially with alpha(1)-blockers 2, 3.
- The concomitant use of PDE5 inhibitors and nitrates is contraindicated due to the risk of profound declines in blood pressure and life-threatening hypotension 2, 3, 5.
Antihypertensive Drugs and Their Impact on ED
- Some antihypertensive drugs may impact ED, and the understanding of common mechanisms involved in the cause of ED associated with hypertension can provide important tools toward identifying new therapeutic targets 6.
- Growing evidence suggests that ED is an early sign of hypertension, and some PDE5 inhibitors used to treat ED can improve blood pressure, but the link between these conditions has not been totally understood 6.