Erectile Dysfunction Among Male Hypertensives in a Tertiary Health Facility in South-West Nigeria

Abstract

Introduction:Erectile dysfunction (ED) has been associated with hypertension and some other chronic diseases. There are few studies on ED in Nigerian male hypertensives and ED appears to be under-reported. We sought to determine the prevalence of ED among hypertensive and normotensive men and to assess the association of demographics, hypertension, antihypertensive medications and other risk factors with erectile function.Methods:A comparative cross sectional study was conducted among male adult hypertensive and normotensive patients attending the outpatient clinic of a tertiary hospital in South-West Nigeria. A systematic random sampling method was employed for the selection of respondents. Participants were interviewed using a semi-structured questionnaire to document socio-demographic data, medical history, social history and degree of ED. Demographic and anthropometric characteristics was obtained from all participants. The International Index of Sexual Health Inventory for men (SHIM) was used to determine the presence and severity of ED. Association between categorical independent variables and erectile function were tested using Chi square and the predictors of erectile dysfunction determined with binary logistic regression model at 5% level of significance.Results:A total of 202 male patients completed the study (101 with established hypertension and 101 normotensives who served as comparative group). The mean age of the respondents was 49.74 ± 16.6 years. A total of 133 (65.8%) respondents had ED in varying severities while 34.2% had normal erectile function. Mild to moderate ED occurred in 29.7% while 36.1% had severe ED. On bivariate analysis, prevalence of ED was higher among hypertensives (75%) than normotensives (56.9%) and this was statistically significant, p = 0.007. On multivariate analysis, the only significant risk factor for ED was age. The elderly aged ≥ 65 years (OR: 2.9; 95% CI: 1.03–8.35; p = 0.04) and those aged 46–64 years (OR: 2.9; 95% CI: 1.38–6.53; p = 0.006) were 3 times each more likely to have erectile dysfunction compared with those aged ≤ 45 years.Conclusion:This study revealed that erectile dysfunction was prevalent in both hypertensive and normotensive population studied and that this was significantly worse with increasing age. A higher proportion of hypertensives compared to normotensives had erectile dysfunction. We recommend that all men presenting to a physician should have routine evaluation for ED so as to recognise it early and reduce its effects.

Erectile Dysfunction Among Hypertensive Patients in Yaounde, Cameroon

“…In this study, the odds of having erectile dysfunction was 4.8 times higher for patients aged between 50 and 60 years, and 5.2 for those aged between 60 and 70 years. These results are similar to those of Fafiolu et al in Nigeria, who found that the risk of erectile dysfunction was multiplied by 3 in hypertensive patients aged above 65 years [9].…”

“…These results are similar to those obtained by a study in Thailand, who had a fourfold increase in the prevalence erectile dysfunction in patients with hypertension for more than 5 years [8]. This finding can be explained by the progression of atherosclerosis and endothelial dysfunction with increasing duration and severity of hypertension [9].…”

“…This value is similar to 56.2% and 53% obtained by studies done in Togo and Thailand [3,8]. In Nigeria, Fafiolu et al had a prevalence of 65.8% which is higher than ours [9]. A study done among hypertensive patients in England by Aranda et al found a prevalence of 35%, which is lower than what we obtained [10].…”

Sexual functioning and health-related quality of life in men

“…ED prevalence rates as high as that reported in this study have been documented among patients with chronic illnesses. 21 22 23 However, lower figures have been reported in individuals without chronic illnesses. 3 7 24 25 The wide variation in the prevalence of ED in these studies may be due to differences in methodologies, participant selection, and subjective experiences.…”

Prevalence and factors associated with erectile dysfunction among adult men in Moshi municipal, Tanzania: community-based study

“…A study done by Fafilou and colleagues [24] showed that men aged 45 years, or more were 3 times more likely to have ED compared to men aged less than 45 years. The variability of our study from others is due to the difference in comparison group where men aged 55 years and above were compared to men aged 18-39 years while in massachusettes [25], the comparison was between men aged 40 and 70 years and in Fafilou's study [24], the comparison was between those aged less than 45 to those of 45 or more years. In spite of comorbidities associated with age, there is decrease in sexual function among men as they age which explains the higher prevalence of ED [26].…”