Does losartan cause ed
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Losartan and Erectile Dysfunction: A Comprehensive Review
Introduction to Losartan and Erectile Dysfunction (ED)
Erectile dysfunction (ED) is a common issue, particularly among men with diabetes and hypertension. Losartan, an angiotensin II receptor blocker (ARB), is primarily used to manage hypertension and diabetic nephropathy. However, its effects on erectile function have been a subject of interest in recent research.
Losartan's Role in Diabetic Erectile Dysfunction
Mechanism of Action in Diabetic ED
Research indicates that the renin-angiotensin system (RAS) plays a significant role in the pathogenesis of diabetic ED. In diabetic rats, components of the RAS, such as angiotensinogen and angiotensin-converting enzyme (ACE), are upregulated, leading to increased angiotensin II (Ang II) levels in the corpora cavernosa. This overactivity contributes to ED. Losartan, by blocking the effects of Ang II, downregulates these components and partially restores erectile function1.
Clinical Trials in Diabetic Patients
A clinical trial involving 124 diabetic patients with ED demonstrated that losartan significantly improved erectile function. The study used the International Index of Erectile Function (IIEF-5) questionnaire and found that losartan, either alone or in combination with tadalafil, improved scores and successful intercourse rates. The combination therapy was more effective than monotherapy, particularly in patients with mild to moderate ED4.
Losartan and Hypertensive Erectile Dysfunction
Comparative Studies with Other Antihypertensives
Hypertension and traditional antihypertensive drugs are often associated with ED. However, studies suggest that losartan may have a beneficial effect on erectile function. In a randomized clinical trial involving hypertensive men, losartan improved ED more significantly than other antihypertensive regimens, such as thiazide diuretics and ACE inhibitors2. This suggests that losartan could be a preferable option for hypertensive patients experiencing ED.
Benefits in Hypertensive Patients
Further evidence supports that losartan, along with doxazosin, can decrease the incidence of ED in hypertensive patients. This can lead to better compliance with antihypertensive therapy and improved overall treatment outcomes5.
Losartan's Effects on Age-Related Erectile Dysfunction
Mechanism in Aged Rats
The prevalence of ED increases with age, and losartan has shown promise in addressing this issue. In aged rats, losartan suppressed corporal apoptosis and oxidative stress, which are key factors in age-related ED. This suggests that losartan may help restore erectile function by mitigating these underlying pathophysiological processes3.
Conclusion
Losartan appears to have a positive impact on erectile function across various conditions, including diabetes, hypertension, and age-related ED. By downregulating the renin-angiotensin system and reducing oxidative stress, losartan not only manages blood pressure but also improves erectile function. These findings suggest that losartan could be a valuable therapeutic option for patients with ED, particularly those with underlying conditions like diabetes and hypertension.
Sources and full results
Most relevant research papers on this topic
Losartan, an Angiotensin type I receptor, restores erectile function by downregulation of cavernous renin-angiotensin system in streptozocin-induced diabetic rats.
Losartan, an angiotensin type I receptor blocker, partially restores erectile function in diabetic rats by downregulating the cavernous renin-angiotensin system.
Non-RCT
Animal StudyAntihypertensive Drugs and the Sexually Active Hypertensive Male: Benefits of Losartan
Losartan, an angiotensin II receptor blocker, may be a better alternative for male hypertensive patients with erectile dysfunction compared to other treatments.
RCTRestoration of erectile function by suppression of corporal apoptosis and oxidative stress with losartan in aged rats with erectile dysfunction
Losartan effectively restores erectile function in aged rats by suppressing corporal apoptosis and oxidative stress, potentially benefiting age-related erectile dysfunction.
Losartan improves erectile dysfunction in diabetic patients: a clinical trial
Losartan improves erectile function in diabetic patients, especially for mild to moderate cases, and the combination of losartan and tadalafil is more effective than either drug alone.
Non-RCTThe Choice of Antihypertensive Drugs in Patients with Erectile Dysfunction
Doxazosin and losartan may decrease the incidence of erectile dysfunction in hypertension patients, potentially improving blood pressure control and reducing overall treatment costs.
Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy.
Losartan significantly reduces the risk of kidney damage and end-stage renal disease in patients with type 2 diabetes and nephropathy, while maintaining overall cardiovascular health.
RCT
Large Human Trial
Highly CitedLosartan
Losartan effectively reduces the risk of developing kidney disease and death in type 2 diabetes patients, with similar effects to enalapril on kidney function.
Losartan and fetal toxic effects
Losartan exposure during pregnancy may cause fetal toxic effects, including oligohydramnios, pulmonary hypoplasia, hypoplastic skull bones, and death.
Case ReportHighly CitedThe angiotensin-II receptor antagonist, losartan, inhibits LDL lipid peroxidation and atherosclerosis in apolipoprotein E-deficient mice.
Losartan inhibits LDL lipid peroxidation in apolipoprotein E deficient mice, potentially reducing accelerated atherosclerosis.
RCTAnimal StudyHighly CitedEffect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial—the Losartan Heart Failure Survival Study ELITE II
Losartan does not show a significant survival benefit or better tolerability compared to captopril in elderly heart-failure patients, but has fewer adverse effects.
RCTLarge Human TrialHighly Cited