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In Reply: We thank Dr Bursztyn for pointing out the articles describing the effect of low-dose antihypertensive drugs and diet on sexual function in hypertensive overweight patients. The risk of erectile dysfunction is closely linked to the presence of well-recognized risk factors for coronary heart disease. Hypertensive patients are particularly vulnerable to erectile dysfunction as a consequence of both hypertension and the use of antihypertensive medications. The interesting finding that weight loss may counterbalance thiazide-induced erectile dysfunction is particularly welcome in light of recent reappraisal of the use of low-dose diuretics as a primary therapy for hypertension.¹

With respect to Dr Seftel’s comments, in our study there was no evidence for a threshold effect between IIEF-5 score and body mass index—the improvement was seen at any level of erectile dysfunction (mild, moderate, or severe). Of course, the lesser the basal erectile impairment, the higher the likelihood of obtaining a . . . [Full Text of this Article]

Katherine Esposito, MD
katherine.esposito@unina2.it

Francesco Giugliano, MD; Dario Giugliano, MD, PhD
Second University of Naples
Naples, Italy

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