Author(s): Viigimaa M, Doumas M, Vlachopoulos C, Anyfanti P, Wolf J
Sexual dysfunction is a common clinical problem that severely affects the quality of life of both patients and their sexual partners. Sexual dysfunction is currently considered to be of vascular origin in the vast majority of the patients, due to atherosclerotic lesions of the penile arteries. It is thus not surprising that sexual dysfunction is more frequently seen in patients with cardiovascular disease and risk factors than in individuals without such conditions. Several lines of epidemiological data indicate that sexual dysfunction is frequently found in hypertensive patients and its prevalence is even higher when other cardiovascular risk factors co-exist. Guidelines for the management of hypertension either ignored or super- ficially addressed this issue up to now [1–3]. The 2009 reappraisal of European guidelines, however, has included for the first time a statement regarding the relationship between these two conditions and the effects of antihypertensive drugs on sexual function . During the last five meetings of the European Society of Hypertension (ESH), round tables regarding the association between sexual dysfunction, hypertension, and cardiovascular disease have taken place; in addition, a newsletter on this topic has been released by ESH . In autumn 2009, a Working Group on Sexual Dysfunction was founded within the ESH; the inaugural session of this Group was held during the 20th European Meeting on Hypertension, in Oslo at June 2010, with vivid participation of many interested physicians who expressed great interest. The primary aim of the group regards the awareness of all clinicians dealing with hypertensive patients (hypertension specialists, cardiologists, internists, nephrologists, diabetologists, and general practitioners) about the magnitude of the problem, the recognition of sexual dysfunction and its management in hypertensive patients. An equally important objective is to familiarize other medical specialties managing sexual dysfunction (urologists, psychiatrists, gynaecologists) about the potential existence of cardiovascular risk factors (hypertension, hyperlipidaemia, diabetes mellitus) and even asymptomatic cardiovascular disease. We anticipate that our first aim is going to be realized: by providing a forum to interested physicians in our society, in which they can express their clinical experience in this field; by a systematic effort to create a European Network regarding the epidemiology and the management of sexual dysfunction in hypertensive patients, initially based on Hypertension Excellence centres and then spread throughout; and by implementing an intense education programme in collaboration with National Hypertension Societies. Our second objective might be realized by a close collaboration with other societies dealing with sexual dysfunction, such as the Urologic, Gynaecologic, Sexual Dysfunction, Psychiatric, and so on, aiming to organize some joint activities that will promote sexual dysfunction as an ‘early diagnostic window’ for cardiovascular disease.