Do lisinopril cause erectile dysfunction
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Lisinopril and Erectile Dysfunction: Analyzing the Evidence
Introduction to Lisinopril and Erectile Dysfunction
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is commonly prescribed to manage hypertension and heart failure. However, concerns about its potential side effects, including erectile dysfunction (ED), have been raised. This article synthesizes findings from multiple studies to determine whether lisinopril is associated with an increased risk of erectile dysfunction.
Long-term Risk of Erectile Dysfunction with Lisinopril
A comprehensive study examining the 18-year risk of various conditions, including erectile dysfunction, among users of different antihypertensive drugs found no statistically significant difference in the risk of erectile dysfunction between lisinopril, amlodipine, and chlorthalidone 1. This suggests that, over the long term, lisinopril does not pose a higher risk of erectile dysfunction compared to other common antihypertensive medications.
Comparative Effects of Lisinopril and Valsartan on Erectile Function
Another study focused on hypertensive men who required sildenafil to achieve erections compared the effects of lisinopril and valsartan. The study concluded that while both drugs effectively lowered blood pressure, only valsartan was associated with a significant increase in the use of sildenafil, suggesting a potential improvement in sexual desire. This implies that lisinopril may not enhance erectile function to the same extent as valsartan, but it does not necessarily worsen it either 2.
Case Report: Lisinopril and Erectile Dysfunction
A case report highlighted a 38-year-old man who experienced profound erectile dysfunction after starting over-the-counter omeprazole, while on a stable dose of lisinopril. The erectile dysfunction resolved after discontinuing omeprazole, indicating that lisinopril was not the cause of the erectile dysfunction in this case 3. This underscores the importance of considering other medications and factors when evaluating erectile dysfunction.
Combined Antihypertensive Therapy and Erectile Function
A study investigating the combination of lisinopril and amlodipine in hypertensive men with high cardiovascular risk found that this combination did not significantly affect erectile function over a six-month period. Despite achieving significant blood pressure reductions, the erectile function indices remained unchanged, suggesting that lisinopril, even in combination with another antihypertensive, does not adversely impact erectile function 4.
Conclusion
The evidence from multiple studies indicates that lisinopril does not significantly increase the risk of erectile dysfunction compared to other antihypertensive drugs. While it may not improve erectile function as some other medications might, it does not appear to worsen it either. Patients experiencing erectile dysfunction should consider other potential causes and consult their healthcare provider for a comprehensive evaluation.
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Most relevant research papers on this topic
The 18-year risk of cancer, angioedema, insomnia, depression, and erectile dysfunction in association with antihypertensive drugs: post-trial analyses from ALLHAT–Medicare linked data
Lisinopril has a higher risk of angioedema over 18 years, while amlodipine and chlorthalidone have similar risks, while erectile dysfunction risk remains unchanged.
Observational StudyP-10: Different effect of valsartan and lisinopril on sildenafil use in hypertensive men with erectile dysfunction
Valsartan treatment significantly increases sildenafil use in impotent hypertensive men, suggesting Angiotensin II antagonism increases sexual desire.
RCTAbrupt-onset, profound erectile dysfunction in a healthy young man after initiating over-the-counter omeprazole: a case report
Proton pump inhibitors may cause erectile dysfunction in healthy young patients and contribute to erectile dysfunction in older patients.
Case ReportEFFECT OF ANTIHYPERTENSIVE THERAPY ON METABOLIC PROFILE AND ERECTILE FUNCTION IN HYPERTENSIVE MEN WITH HIGH CARDIOVASCULAR RISK: FOCUS ON THE COMBINATION OF LISINOPRIL AND AMLODIPINE
The combination of lisinopril and amlodipine significantly reduced blood pressure in hypertensive men with high cardiovascular risk without affecting plasma lipid profile, glucose, and uric acid levels or erectile function.
Non-RCTSexual function in hypertensive males treated with lisinopril or atenolol: a cross-over study.
Atenolol causes a chronic worsening of sexual activity, while lisinopril causes only a temporary decline in sexual activity in hypertensive males.
RCT
Highly CitedErectile and Ejaculatory Dysfunction Associated with Use of Psychotropic Drugs: A Systematic Review.
Psychotropic drugs, particularly SNRIs, can cause male sexual dysfunction, with a primary role in increased prolactin levels.
Systematic ReviewLisinopril dose-response relationship in essential hypertension.
Lisinopril effectively reduces diastolic blood pressure in essential hypertension patients, with doses up to 80 mg daily being well-tolerated and well-tolerated.
RCTEffect of the ACE inhibitor lisinopril on mortality in diabetic patients with acute myocardial infarction: data from the GISSI-3 study.
Early treatment with lisinopril in diabetic patients with acute MI is associated with a decreased 6-week mortality.
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Large Human TrialHighly CitedLiraglutide Ameliorates Erectile Dysfunction via Regulating Oxidative Stress, the RhoA/ROCK Pathway and Autophagy in Diabetes Mellitus
Liraglutide improves erectile dysfunction in diabetic rats by regulating smooth muscle dysfunction, oxidative stress, and autophagy, without affecting glucose levels.
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Animal StudyErectile dysfunction predicts mortality in middle-aged and older men independent of their sex steroid status.
Sexual symptoms, particularly erectile dysfunction, predict all-cause mortality in middle-aged and older men independently of their sex steroid status.
Observational Study