Possible Side Effects Should Be Discussed with Patients

to the editor: I enjoyed reading the article, “Managing Hypertension in Athletes and Physically Active Patients,”¹ in American Family Physician. As a primary care physician, I concur with the importance of screening this target group of athletes and other physically active persons for high blood pressure, and the emphasis on lifestyle modifications. The article¹ provided an extensive review of pharmacologic therapy, including various drug side effect profiles. However, in my experience with treating patients, sexual dysfunction is a major side effect of antihypertensive medicine that is especially relevant to athletes and physically active patients and is a significant cause of patient noncompliance with medication regimens.^2,3 Up to 25 percent of cases of sexual dysfunction, especially erectile dysfunction, are related to medication side effect.⁴ High blood pressure medicines are commonly associated with various types of sexual dysfunction.

All patients should be informed of the possible side effect of sexual dysfunction, especially athletes and physically active patients, because this may have a tremendous impact on their lives. Family physicians need to be prepared to discuss this issue with patients to avoid noncompliance.