Letters to the Editor

Am Fam Physician. 2003 Mar 15;67(6):1188-1189.

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.

REFERENCES

1. Niedfeldt MW. Managing hypertension in athletes and physically active patients. Am Fam Physician. 2002;66:445–52.

2. Brock GB, Lue TF. Drug-induced male sexual dysfunction. An update. Drug Saf. 1993;8:414–26.

3. Finger WW, Lund M, Slagle MA. Medications that may contribute to sexual disorders. A guide to assessment and treatment in family practice. J Fam Pract. 1997;44:33–43.

4. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993;270:83–90.

Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.

Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.


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