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NITRIC OXIDE, ERECTILE DYSFUNCTION AND BETA‐BLOCKER TREATMENT (MR NOED STUDY): BENEFIT OF NEBIVOLOL VERSUS METOPROLOL IN HYPERTENSIVE MEN

2007; Wiley; Volume: 34; Issue: 4 Linguagem: Inglês

10.1111/j.1440-1681.2007.04551.x

1440-1681

Klara Brixius, Martin Middeke, A. Lichtenthal, E M Jahn, Robert H. G. Schwinger,

Pharmacology and Obesity Treatment

SUMMARY Hypertensive men treated with beta‐blockers frequently complain of erectile dysfunction. The present study investigated the effects of two β 1 ‐adrenoceptor‐selective antagonists, namely nebivolol and metoprolol, on erectile function in hypertensive men. Male out‐patients (age range 40–55 years) with newly diagnosed or existing stage 1 essential hypertension (mean seated systolic blood pressure 140–159 mmHg; diastolic blood pressure 90–99 mmHg) were enrolled in the study. All patients lived in a stable, heterosexual partnership and had no history of sexual dysfunction. After a 2 eek placebo run‐in period, patients were randomized double‐blind to either Treatment group A (comprising nebivolol 5 mg once daily for 12 weeks, followed by placebo for 2 weeks and then metoprolol succinate 95 mg once daily for 12 weeks) or Treatment group B (comprising metoprolol succinate 95 mg for 12 weeks, placebo for 2 weeks and then nebivolol 5 mg for 12 weeks). An international index of erectile function (IIEF) questionnaire and a diary documented patients’ sexual function and activity. Nebivolol and metoprolol lowered blood pressure to a similar extent. Metoprolol, but not nebivolol, significantly decreased the IIEF erectile function subscore by 0.92 in the first 8 weeks after onset of beta‐blocker treatment. In contrast with metoprolol, nebivolol improved secondary sexual activity scores and other IIEF subscores. Despite similar antihypertensive efficacy of the cardioselective β 1 ‐adrenoceptor antagonists nebivolol and metoprolol, nebivolol may offer additional benefits by avoiding erectile dysfunction in male hypertensive patients on long‐term β‐adrenoceptor antagonist therapy.