Sexual Dysfunction and BPH Medications
There are three FDA approved medications for erectile dysfunction in men (e.g., sildenahl/Viagra, tadalahl/Cialis, and vardenahl/Levitra). All of these medications work by increasing blood flow to the penis and thereby have an increased risk of hypotension. Caution should be used in those who are taking antihypertensive medications, alpha blockers for benign prostatic hyperplasia (BPH) (e.g., tamsulosin), or nitroglycerines . Administration of alpha blockers at bedtime, instead of morning, may limit daytime orthostasis.
Hypertension is extremely common in the general population, with a prevalence of 60%-80% in the older adult . Diuretics have the most serious side-effect prohle due to the increased risks of hypotension, dizziness, electrolyte disturbances, and falls. Commonly prescribed diuretics include furosemide and hydrochlorothiazide . All antihypertensives have the potential to cause hypotension and orthostasis. Modihed guidelines from the JNC-8 suggest that hypertension in those >60 years of age, should only be treated if measurements exceed >150 mm Hg for systolic or >90 mm Hg for diastolic pressure .