Management of erectile dysfunction: Do not forget hypertension - Reply

摘要

We appreciate thoughtful and insightful comments of Doumas et al.The population in the Look AHEAD (Action for Health in Diabetes) trial1 consisted of older, obese men with type 2 diabetes mellitus. In this specific population, a combination of angiotensin-converting enzyme inhibitors, diuretics, and beta-blockers is often required to achieve optimal blood pressure control. Although, a third-generation beta-blacker such as nebivolol hydrochloride2 is also available, which improves sexual function with an endothelial nitric oxide— generating property. However, a paucity of data on safety and efficacy of nebivolol in combination with other antihy-pertensive medications limits its use in the elderly diabetic population. Investigators in the Look AHEAD trial analyzed the phosphodiesterase 5 inhibitor user status and demonstrated no significant effects on erectile dysfunction. We also reported that the lifestyle intervention improved erectile dysfunction not responding to phosphodiesterase 5 inhibitors.