Risk factors for erectile dysfunction are also risk factors for coronary artery disease. These include diabetes, smoking, lipid abnormalities (low levels of high-density lipoprotein cholesterol, high levels of total cholesterol), hypertension, obesity and lack of physical activity.

This review will focus on hypertension as a risk factor for erectile dysfunction; the effect of the phosphodiesterase 5 inhibitors (PDE5 inhibitors: sildenafil, vardenafil and tadalafil) on systemic arterial blood pressure (BP); the effect of the PDE5 inhibitors in men with erectile dysfunction and hypertension taking antihypertensive medicines; the contraindication of PDE5 inhibitors in the setting of organic nitrates; and the effect of PDE5 inhibitors when administered with alpha blockers.

The Association of Hypertension with Erectile Dysfunction
Hypertension or high BP, defined as a BP of =140 mm Hg systolic and/or =90 mm Hg diastolic is estimated to affect approximately 50 million Americans. As the US population ages hypertension is predicted to increase. Several studies have linked hypertension with erectile dysfunction. In the Massachusetts Male Aging study of 1994, Feldman et al. reported the presence of erectile dysfunction in 9.6% of a general population and 15% in patients with treated hypertension. More recent analyses of hypertensive patients suggest that the prevalence of erectile dysfunction in hypertensive populations is even higher. Thus, patients with hypertension are more likely to have erectile dysfunction; and patients with erectile dysfunction are more likely to have hypertension.