ESC 2020:降压药影响男性性功能吗?研究揭示,如何在不破坏性生活的前提下治疗高血压

2020-09-07 佚名 心关注

降压药会影响男性性功能吗?2020年8月28日在ESC 2020大会上公布的一项研究研究显示,未经治疗的男性高血压患者阴茎血流比血压正常的男性差,在降压治疗后这种差异消失了。

降压药会影响男性性功能吗?2020年8月28日在ESC 2020大会上公布的一项研究研究显示,未经治疗的男性高血压患者阴茎血流比血压正常的男性差,在降压治疗后这种差异消失了。这项研究结果让那些关心降压药物对性功能影响的男性感到安心。

高血压影响全球超过10亿人群,是导致过早死亡的主要原因。各大指南均建议养成健康的生活方式,包括限制盐、适度饮酒、运动、控制体重和戒烟。大多数患者还需要药物治疗,这与降低死亡、卒中和心脏病的风险有关,但大约有一半的患者不吃药。性功能障碍是患者停药的原因之一。

与血压正常的男性相比,患有高血压的男性阴茎血流受损和勃起功能障碍的可能性几乎是正常男性的两倍,这增加了他们患心脏病和死亡的风险。高血压会损害动脉壁,导致动脉壁变硬、变窄,减少流向阴茎的血液流量。勃起功能障碍是血管受损的早期预警信号。然而,既往研究表明,勃起功能障碍在经治疗的男性高血压患者中比未经治疗的男性更为常见。某些抗高血压药物,特别是利尿剂和β受体阻滞剂,已被证实与性功能恶化有关。这项研究检查了血压水平和阴茎血流量之间的关系,以及降压药物是否对这种关系有影响。

这项研究纳入了2006年至2019年间一家诊所的356名患有勃起功能障碍,没有糖尿病心血管疾病病史的男性患者。队列根据血压分为三类:正常、正常高压和高血压。共有164名患者(46%)接受抗高血压药物治疗。

所有患者都接受了阴茎彩色多普勒超声检查,这是评估阴茎血管和勃起功能障碍的标准方法。这种方法包括向阴茎根部注射一种药物以打开血管,然后测量血流。当流速低于25 cm/s时,阴茎血流被认为是受损的。

在未接受抗高血压药物治疗的男性中,阴茎血流速度随着血压升高而逐渐降低,即血压正常者血流速度最快,正常高压者血流速度较慢,高血压患者血流速度最慢(见图)。相反,在接受抗高血压治疗的男性中,三种血压类型之间的阴茎血流速度没有差异。

该研究作者、雅典国立卡波季斯特里安大学的Charalambos-Vlachopoulos教授介绍道,不服用抗高血压药物的男性在三种血压水平上的阴茎血流速度逐渐降低,这表明长期高血压导致阴茎血管结构发生显着变化。三种血压类型的血流差异随着治疗的进行而消失,这表明药物治疗有效果。

另一项分析比较了每个血压组中接受治疗和未治疗的男性。在高血压组,治疗组和未治疗组的阴茎血流速度相似。然而,在正常高压组,接受治疗的男性阴茎血流比未治疗的男性差。同样,在血压正常的情况下,接受治疗的男性比未接受治疗的男性阴茎血流更差。

Vlachopoulos教授说:“这些结果意味着高血压患者阴茎动脉已经出现了明显的结构损伤,添加抗高血压药物并不能进一步减少阴茎血流量。但在血压正常或正常高的男性中,阴茎动脉的结构损伤最小,药物可能会对阴茎血流产生负面影响。”

他敦促那些担心性功能障碍的男性和他们的医生讨论这个问题。他说:“对于尚未接受治疗的高血压患者,较老的药物(β受体阻滞剂和利尿剂)并不理想,只有在绝对必要的情况下才应该使用。”

Vlachopoulos教授指出,对于勃起功能障碍的男性,更换高血压药物必须谨慎处理。

首先,如果一个共同存在的疾病要求使用特定的药物类别(例如,用于冠心病和心力衰竭的β受体阻滞剂,用于心力衰竭的利尿剂),那么就不提倡转换。如果患者因勃起功能障碍对其生活造成不利影响而面临停止救生治疗的风险,则可以考虑替代方案。

第二,改用其他药物并不能保证勃起功能的恢复或改善。这必须事先向患者仔细解释,避免不合理的预期。”。

Vlachopoulos教授总结道,这项研究表明,高血压可以在不引起勃起功能障碍的情况下得到治疗。患者和医生需要进行公开讨论,以找到最佳治疗方案。

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    2020-11-12 570547969

    学习了

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    2020-10-12 92721

    要更深入讨论一下

    0

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    2020-09-09 Lexi

    与患者沟通也是非常重要的

    1

    展开1条回复
  4. 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    2020-09-09 qindq
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time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883429, encodeId=cc0a88342971, content=<a href='/topic/show?id=3231981537e' target=_blank style='color:#2F92EE;'>#降压药#</a>影响男性<a href='/topic/show?id=3f595265153' target=_blank style='color:#2F92EE;'>#性功能#</a>吗?如何在不破坏性生活的前提下治疗<a href='/topic/show?id=1c1710265113' target=_blank style='color:#2F92EE;'>#高血压#</a>,这又成为一个新话题了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=223, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98153, encryptionId=3231981537e, topicName=降压药), TopicDto(id=52651, encryptionId=3f595265153, topicName=性功能), TopicDto(id=102651, encryptionId=1c1710265113, topicName=高血压)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Mon Sep 07 22:34:00 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883426, encodeId=a22e88342680, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon Sep 07 22:27:30 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
    2020-09-08 杀无敌战神

    学习

    0

  7. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883426, encodeId=a22e88342680, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon Sep 07 22:27:30 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
    2020-09-07 ms9000000058794467

    谢谢分享

    0

  8. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883426, encodeId=a22e88342680, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon Sep 07 22:27:30 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
    2020-09-07 Jessica

    与降压药会不会导致抑郁相比,“降压药会影响男性性功能吗”这个话题更吸引人。

    0

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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883426, encodeId=a22e88342680, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon Sep 07 22:27:30 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
    2020-09-07 lovetcm

    #降压药#影响男性#性功能#吗?如何在不破坏性生活的前提下治疗#高血压#,这又成为一个新话题了。

    0

  10. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883945, encodeId=84bc88394577, content=与患者沟通也是非常重要的, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae205385871, createdName=Lexi, createdTime=Wed Sep 09 18:27:56 CST 2020, time=2020-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292085, encodeId=73bd12920851e, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Wed Sep 09 12:37:33 CST 2020, time=2020-09-09, status=1, ipAttribution=), 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=883426, encodeId=a22e88342680, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon Sep 07 22:27:30 CST 2020, time=2020-09-07, status=1, ipAttribution=)]
    2020-09-07 wxl882001

    了解

    0

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