Do you know Ed causes high blood pressure??

If you’re struggling with erectile dysfunction (ED), you’re not alone. More than half of all American men will experience ED in their lifetime. Not only can this condition pump the brakes on your sex life, but it can also be a source of frustration and embarrassment.

Because so many men are affected by ED, there’s no shortage of information out there about what you can do to resolve this condition. But many sources fail to explain how high blood pressure, a condition more than half of American adults have, can contribute to your ED.

At Urological Associates in Charlottesville, Virginia, our board-certified urologists specialize in helping men overcome ED and reclaim their sex life. Our practice offers personalized ED treatment and a variety of therapeutic modalities.

We also believe in the power of patient education, so we’ve put our heads together to give you the information you need to understand the link between high blood pressure and ED.

Chronic high blood pressure, or hypertension, develops for different reasons, including medical conditions like kidney disease, and lifestyle choices like smoking or a diet high in sodium. Sometimes people develop high blood pressure without an identifiable cause.

Regardless of why you have hypertension, untreated chronic high blood pressure damages your heart and blood vessels and eventually leads to life-threatening medical conditions like heart disease and stroke. And because the condition doesn’t come with noticeable symptoms, doctors call it “the silent killer.”

Erectile dysfunction is the term used to describe a condition in which men cannot maintain an erection, get a full erection, or have an erection at all.

While erections may seem simple, the truth is that many different systems must work together for you to get and maintain an erection, including your muscles, cardiovascular system, brain, nerves, emotions, and hormones.

Your blood vessels play one of the main roles in achieving an erection since blood flow is key to penile function. Anything that impacts your vascular health and the way blood flows in your body can cause or contribute to ED, including:

Sometimes addressing these underlying health issues works to resolve or minimize erectile dysfunction. If you’re experiencing any chronic erectile issues, talk to your provider at Urological Associates for an accurate diagnosis.

About 80% of the time, erectile dysfunction has a physical cause with the most common cause being hypertension. In fact, men with chronic high blood pressure are twice as likely to have ED. And since ED is underreported, researchers estimate the numbers could be much higher.

This is because hypertension damages your blood vessels and arteries, making it impossible for the arteries that supply blood to your penis to function as they’re supposed to. This also affects the muscle in the penis by creating an inability to relax. The result? Your penis doesn’t get enough blood to make it erect or keep it erect.

In addition, your risk of having low testosterone is nearly two times higher if you have hypertension. While the relationship between hypertension and low testosterone is still being investigated, having low testosterone can contribute to erectile problems and low libido.

Getting high blood pressure under control is imperative for your overall health. This silent killer causes or contributes to nearly half million deaths every year, but only 1 in 4 adults with hypertension have it managed.

It’s important to take steps to lower your blood pressure, both through lifestyle changes and medications, if recommended by your doctor. Unfortunately, many of the medications prescribed to help lower blood pressure can make your ED worse since they impact blood flow.

There’s good news, however, for men with both high blood pressure and ED. The team at Urological Associates offers many treatments that address ED and are safe to use with blood pressure medications, including:

Men with high blood pressure sometimes experience problems getting or keeping an erection that’s hard enough for sex. But lowering your blood pressure through a healthy lifestyle, and medications if you need them, can be all you need to improve your erections.

Problems getting an erection can even be a sign of high blood pressure, damaged blood vessels and heart disease. If you have problems getting an erection and don’t know your blood pressure numbers, speak to your GP and get a blood pressure check. It could save you from having a stroke or heart attack.

When you are sexually aroused, your brain sends signals to the nerves in and around the penis. These nerves cause more blood to flow into the penis and for the tissue and blood vessels to relax and open up, allowing blood to flow in to the penis, making it hard.

High blood pressure can damage your blood vessels throughout your body, including the blood vessels in or leading to the penis. They can become too narrow (this is called atherosclerosis), meaning not enough blood can flow through them.

Diabetes, smoking and drinking a lot of alcohol are all major causes of erectile dysfunction. Combined with high blood pressure, these can all damage the blood vessels, putting you at higher risk of heart disease and stroke.

There are a number of other possible causes, including:

Your doctor will ask you about the problems you’re having as well as any other medical conditions and your overall health and wellbeing. They will also check your blood pressure and heart rate and do a physical exam.

These will help your doctor understand the cause of the problem and any underlying health problems that need treating, such as high blood pressure and high cholesterol which could mean you’re at risk of heart attacks, heart disease and stroke.

There are a number of ways to improve your erections. Speak to your doctor about the options that could work for you.

If your erectile dysfunction is caused by high blood pressure, then lowering your blood pressure with healthy changes to your lifestyle, could be enough to improve your erections without any other treatments. These changes will also improve your overall health and lower your risk of serious problems such as heart disease, stroke and diabetes.

You might also be offered blood pressure-lowering medicines if you need them.

If the problem is caused by blood pressure medications, your doctor may be able to lower your dose or try a different medication. Don’t stop taking your medicines without speaking to your doctor first as your blood pressure will quickly go back up.

If your erectile dysfunction is caused by medication for another health problem, your doctor may also be able to try an alternative for this.

If you have an underlying health problem which is causing your erectile dysfunction your doctor will try to find the best treatment for it. For example, cholesterol-lowering drugs, called statins, to treat atherosclerosis.

There are treatments available to help you get an erection which can be used at the same time as changing your lifestyle or blood pressure medications, or afterwards, if you’re still having problems.

Treatments include vacuum pumps, which are devices that encourage blood to flow into the penis. Tablets called PDE5 inhibitors, such as Viagra, can also be an option. Because they allow the blood vessels to widen they can cause lightheadedness, especially if you are taking blood pressure medications, so you will start with a low dose and they might not be suitable if you have angina (chest pain).

Speak to your doctor about which options might be right for you.

It’s normal to feel embarrassed and find it difficult to talk about sex and erections. But sex is a normal part of life and problems getting an erection are very common, so your doctor or nurse will be used to talking about these things. They can talk to you in confidence about any questions or concerns you may have and the treatment options available.

If sex is important to you, not being able to get an erection can have a big impact on your mood and how you feel about yourself, so it’s important to get the support and treatment you need. If you’ve had problems getting an erection this can affect your confidence, which can in turn affect your ability to get an erection. You might find it helpful to speak to a counselor or specialist. They are experts in helping people to overcome these problems.

You can speak to your GP or practice nurse, visit a genitourinary medicine (GUM) clinic or ask to be referred to a specialist. Find the nearest GUM clinic through the British Association for Sexual Health and HIV (BASHH) website.

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Hypertension (high blood pressure) affects more than one billion people worldwide and is the leading cause of premature death.2 A healthy lifestyle is advised, including salt restriction, alcohol moderation, exercise, weight control, and smoking cessation. Most patients also require drug treatment, which is linked to reduced risks of death, stroke, and heart disease – but around half of patients do not take their pills. Sexual dysfunction is one reason why patients stop medication.

Men with hypertension are almost twice as likely to have impaired penile blood flow and erectile dysfunction compared to men with normal blood pressure, increasing their risk of heart disease and death. High blood pressure damages artery walls, causing them to harden and narrow, and reducing blood flow to the penis. Erectile dysfunction is an early warning sign of damaged blood vessels.

However, previous studies have shown that erectile dysfunction is more common in treated, than untreated, men with high blood pressure. And certain antihypertensive drugs – notably diuretics and beta blockers – have been linked with deterioration in sexual function. This study examined the association between blood pressure level and penile blood flow, and whether blood pressure-lowering medication had an effect on the relationship.

The study included 356 men with erectile dysfunction and no history of diabetes or cardiovascular disease who attended a clinic between 2006 and 2019. The cohort was divided into three categories according to blood pressure: normal, high-normal, and hypertension. A total of 164 (46%) patients were being treated with antihypertensive medications.

All patients underwent a penile colour Doppler ultrasound which is the standard method for evaluating penile blood vessels and erectile dysfunction. The method involves injecting a drug into the base of the penis to open the blood vessels then measuring blood flow. Penile blood flow is considered impaired when the velocity is lower than 25 cm/s.

Among men not receiving antihypertensive medication, penile blood flow velocity progressively decreased with rising blood pressure – i.e. blood flow was fastest in those with normal blood pressure, slower in those with high-normal blood pressure, and slowest in those with hypertension (see Figure). In contrast, among men taking antihypertension therapy, there was no difference in penile blood flow velocity between the three blood pressure categories.

“The progressive decrease in penile blood flow velocity across the three blood pressure categories in men not taking antihypertensive medication indicates significant structural changes in the penile blood vessels from longstanding hypertension,” said study author Professor Charalambos Vlachopoulos of the National and Kapodistrian University of Athens, Greece. “The blood flow differences across the three blood pressure categories disappeared with treatment, suggesting a medication effect.”

An additional analysis compared treated and untreated men within each blood pressure group. In the hypertension category, treated and untreated patients had similar penile blood flow velocities. However, in the high-normal category, treated men had worse penile blood flow than untreated men. Similarly, in the normal blood pressure category, treated men had worse penile blood flow than untreated men.

Professor Vlachopoulos said: “These results imply that hypertensive patients already have significant structural damage in the penile arteries and adding antihypertensive drugs does not further reduce penile blood flow. But in men with normal or high-normal blood pressure, the penile arteries have minimal structural damage and medications could have a negative impact on penile blood flow.”

He urged men with concerns about sexual dysfunction to discuss it with their doctor. “For men with as yet untreated hypertension, older medications (beta blockers and diuretics) are not ideal and should be used only if absolutely indicated,” he said.

Professor Vlachopoulos noted that changing hypertensive medications in men with erectile dysfunction must be handled with caution. He said: “First, if a co-existing disease dictates using a specific drug category (for example, beta blockers for coronary artery disease and heart failure, diuretics for heart failure), then switching is not advocated. Alternatives might be considered if patients are at risk of stopping lifesaving therapy because of the detrimental impact of erectile dysfunction on their life.”

“Second, switching to another drug class does not guarantee either the restoration or improvement of erectile function. This has to be carefully explained to patients in advance to avoid unreasonable expectations,” he said.

Professor Vlachopoulos concluded: “Our study shows that high blood pressure can be treated without causing erectile dysfunction. Patients and doctors need to have open discussions to find the best treatment option.”

Figure: Penile blood flow velocity across blood pressure categories in treated and untreated men

About 80% of the time, erectile dysfunction has a physical cause with the most common cause being hypertension. In fact, men with chronic high blood pressure are twice as likely to have ED. And since ED is underreported, researchers estimate the numbers could be much higher.

• ACE inhibitors.
• Calcium channel blockers.
• ARBs.