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Unravelling the puzzle: Tips for managing erectile dysfunction in hypertensive patients

Dr. Joe Lee
Consultant, Director of Andrology and Male Reproductive Medicine,
Department of Urology, National University Hospital
Assistant Professor, National University of Singapore
12 Apr 2018
·  A 70-year-old male with a history of diabetes, hyperlipidaemia and hypertension managed with atenolol presented to his family physician with lower urinary tract symptoms (LUTS) 
·  He was prescribed terazosin 
·  Over the course of a year he noticed worsening erectile dysfunction (ED) with difficulty maintaining a hard erection until orgasm 
·  His International Index of Erectile Function (IIEF-5) score was 7/25 
·  His antihypertensive medication was changed from atenolol to amlodipine and he was given a trial of sildenafil 100 mg on-demand, after initiating at 50mg
·  The patient had a good response to sildenafil on various occasions with an IIEF-5 score of 18/25. However, he experienced two episodes of giddiness after taking sildenafil with terazosin at night
·  Symptoms of postural hypotension improved after switching from terazosin to controlled-release doxazosin.1,2 The dose of amlodipine was also reduced by half

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Most Read Articles
5 days ago
Prenatal and postpartum vitamin D supplementation does not appear to improve foetal or infant growth, a study reports.
6 days ago
Excessive daytime sleepiness appears to increase the long-term risk of amyloid β (Aβ) deposition, a recent study has shown.
13 Sep 2018
Substituting diets high in carbohydrates with those high in monounsaturated fatty acids in the context of low saturated fatty acids do not appear to yield favourable effects on blood pressure, according to a meta-analysis.
3 days ago
Patients with chronic kidney disease appear to be at greater risk of developing type 2 diabetes mellitus (T2DM) compared with the general population, with predictors including poor baseline glycaemic control and family history of diabetes mellitus, a study has found.