The Combination Therapy On The Effect Of The Treatment And The Sexual Function In Young And Middle-aged Women With Hypertension

Objective We evaluated the prevalence of female sexual dysfunction(FSD) and the different combination therapy on the effect of blood pressure lowering and the sexual function in young and middle-aged hypertensive women.Methods Prospective, randomized, parallelized, controlled and fixed combination therapy was carried out.A total of 50 normnotesive women(control) and 99 female patients(aged 18 to 60) who were diagnosed with grade 1 and grade 2 hypertension(BP>140/90mmHg and<179/109mmHg) in The Second Hospital of Lanzhou University were enrolled. The Female Sexual Function Index(FSFI) questionnaire, levels of serum estradiol and testosterone were assessed in the normotensive women and the two different hypertensive groups.The fixed combined therapeutic programs which are Felodipine 5mg q.d+Irbesartan 150mg q.d(F+I group,n=49) and Felodipine 5mg q.d+Metoprolol 47.5mg q.d(F+M group,n=50) within 48 weeks follow up.Tartet blood pressure should be at least<140/90 mmHg according The Chinese Hypertension Guideline of 2005. Female sexual dysfunction was defined as an FSFI score of less than 25.5.Results There were no statistical differences in the blood pressure control between 2 groups in the 4th,8th,12th,24th,36th and 48th week respectively(p>0.05). FSD was found in 66.7% of hypertensive group(F+I group and F+M group) compared with 30% of normotensive women. There were statistical differences in the prevalance of FSD between the control group and the hypertensive group(P=0.000).In the hypertensive group,scores for the items related to "sexual desire", " arousal", "lubrication", "orgasm", "pain" and the level of the serum estradiol are lower than those of the control group(P<0.01).The contentration of the serum testosterone is higher(P=0.000).The level of the serum estradiol of the control group is higher than that of the F+I and F+M treated women included premenopausal and postmenopausal people respectively(P<0.01). The contentration of the serum testosterone of the control group is higher than that of the F+I (P=0.005)and the F+M treated premenopausal women(P=0.042).There were no statistical differences in the level of the serum testosterone among the F+I postmenopausal women,the F+M postmenopausal women and the postmenopausal control group(P=0.054).After 24 weeks treatment, the F+I treated women included premenopausal and postmenopausal people,scores for the items related to "sexual desire" and "arousal" were significantly improved and the level of the serum estradiol was elevated(P<0.05 or P＜0.01 respectively).Meanwhile,the level of the serum testosterone was decreased(P<0.05 or P<0.01 respectively).In contrast,in the F+M treated women included premenopausal and postmenopausal people,scores for the items "sexual desire" and "lubrication" were statistically lower and the concentration of the serum estradiol was less than that of the initiated time of the trial(P＜0.01).The level of the serum testosterone was higher(P<0.01).There were no statistical differences in the scores for the items related to "desire", "arousal", "lubrication", "orgasm' satisfaction" and "pain" between the 48 weeks and the 24 weeks after treatment.Levels of serum estradiol and testosterone between the 24th and 48th weeks were also similar.In the hypertension group,FSFI score was positively correlated with the level of serum estradiol and a negative correlation with systolic blood pressure levels.Conclusion FSD is more prevalent in women with essential hypertension compared with women with normal blood pressure.Felodipine combined with Irbesartan or Metoprolol for 48 weeks had similar ability for blood pressure lowering.Felodipine combined Irbesartan improved sexual function to a certain extent in female hypertensive patients.