Sexual health is an integral part of overall health, and an active and healthy sexual life is an essential aspect of a good life quality. Cardiovascular disease and sexual health share common risk factors (arterial hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking) and common mediating mechanisms (endothelial dysfunction, subclinical inflammation, and atherosclerosis). This generated a shift of thinking about the pathophysiology and subsequently the management of sexual dysfunction. The introduction of phosphodiesterase type 5 inhibitors revolutionized the management of sexual dysfunction in men. This article will focus on erectile dysfunction and its association with arterial hypertension. This update of the position paper was created by the Working Group on Sexual Dysfunction and Arterial Hypertension of the European Society of Hypertension. This working group has been very active during the last years in promoting the familiarization of hypertension specialists and related physicians with erectile dysfunction, through numerous lectures in national and international meetings, a position paper, newsletters, guidelines, and a book specifically addressing erectile dysfunction in hypertensive patients. It was noted that erectile dysfunction precedes the development of coronary artery disease. The artery size hypothesis has been proposed as a potential explanation for this observation. This hypothesis seeks to explain the differing manifestation of the same vascular condition, based on the size of the vessels. Clinical presentations of the atherosclerotic and/or endothelium disease in the penile arteries might precede the corresponding manifestations from larger arteries. Treated hypertensive patients are more likely to have sexual dysfunction compared with untreated ones, suggesting a detrimental role of antihypertensive treatment on erectile function. The occurrence of erectile dysfunction seems to be related to undesirable effects of antihypertensive drugs on the penile tissue. Available information points toward divergent effects of antihypertensive drugs on erectile function, with diuretics and beta-blockers possessing the worst profile and angiotensin receptor blockers and nebivolol the best profile.

Background and Objectives: Only a few studies have reported the pre-practice hydration status in soccer players (SPs) who train in a cool climate. The primary purpose of this study was to examine the hydration status of male semiprofessional SPs immediately before their regular training session in winter. The secondary purpose was to compare the urinary indices of the hydration status of Estonian and Latvian SPs. Materials and Methods: Pre-training urine samples were collected from 40 Estonian (age 22.1 ± 3.4 years, soccer training experience 13.7 ± 3.9 years) and 41 Latvian (age 20.8 ± 3.4 years, soccer training experience 13.3 ± 3.0 years) SPs and analyzed for urine specific gravity (USG). The average outdoor temperature during the sample collection period (January–March) was between −5.1 °C and 0.2 °C (Estonia) and −1.9 °C and −5.0 °C (Latvia). Results: The average pre-training USG of Estonian and Latvian SPs did not differ (P = 0.464). Pooling the data of Estonian and Latvian SPs yielded a mean USG value of 1.021 ± 0.007. Hypohydration (defined as a USG ≥ 1.020) was evident altogether in fifty SPs (61.7%) and one of them had a USG value greater than 1.030. Conclusions: Estonian and Latvian SPs do not differ in respect of USG and the prevalence of pre-training hypohydration is high in this athletic cohort. These findings suggest that SPs as well as their coaches, athletic trainers, and sports physicians should be better educated to recognize the importance of maintaining euhydration during the daily training routine in wintertime and to apply appropriate measures to avoid hypohydration.

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