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Erectile dysfunction is among the common complaints in men with hypertension. High blood pressure or hypertension is a chronic condition that is highly prevalent in adult men due to factors like smoking, alcohol consumption, unhealthy diet, stress and lack of exercise. 
According to the definition by the National Institute of Health, erectile dysfunction is the persistent inability of a person to maintain penile rigidity which is required to reach sexual satisfaction. Erectile dysfunction highly affects the overall health of sexually active sex.
When both the conditions erectile dysfunction and hypertension occur in a person, they cause a great influence on the quality of life of men and also their partners. But, how are they related?
In this article, we will discuss how erectile dysfunction is linked to hypertension. Take a look.
How Does Erectile Dysfunction Occur?
Before understanding the link between erectile dysfunction and hypertension, we need to first understand the mechanism of erection. The erection mainly occurs:
- When the sensory nerves pass the message of arousal to the brain to stimulate the penis. Upon receiving the message, the brain signals the muscles of the corpora cavernosa (erectile tissues of the penis) to relax, thus allowing the blood flow.
- When the blood starts flowing into the open spaces of the penis, it creates pressure, making it to expand and create an erection.
- The membrane around the corpora cavernosa helps hold the blood and maintain the erection for longer.
- The erection is lost when the muscles of the penis contract and stop the flow of blood inwards and open the channel to move the blood out.
Erectile Dysfunction And Hypertension: How Are They Linked?
A study has shown that approximately 30 per cent of men with hypertension often complain about erectile dysfunction. Also, by the year 2025, experts predict that around 322 million men may be suffering from erectile dysfunction. 
Both the conditions are considered closely intertwined diseases mainly due to factors like cellular dysfunctions, usage of antihypertensive drugs or both.
1. Cellular dysfunctions
As aforementioned, penile tissues are the ones that allow the flow of blood and maintain homeostasis to sustain the erection.
Hypertension can remodel the blood vessels and make them weak, narrow or leak. As the penis is also a vascular organ marked by high blood flow, high blood pressure can decrease its elastic fibres, increase the collagen deposition that may lead to clots and thin the tunica albuginea which are fibrous envelopes that help in the erection.
Due to the blood flow changes in people with hypertension, the blood flow of the penis is also affected, leading to damage to its vessels and reducing supply to the penis, thus causing erectile dysfunction.
2. Antihypertensive drugs
As hypertension is a chronic condition, the medicine needs to be consumed life-long along with vital lifestyle changes. Some of the medicines used to treat high blood pressure include diuretics, direct vasodilators, sympathoplegic agents, antagonists and certain inhibitors.
Among them, some first line antihypertensive drugs like beta-blockers and diuretics may lead to erectile dysfunction as a common side effect. Beta-blockers are known to reduce blood pressure by reducing cardiac output while diuretics reduce the body sodium stores that in turn, reduces the total blood volume and then, cardiac output. 
Though these medications show positive effects on hypertension, they can deeply affect the nerves, hormones and blood circulation of the penis, leading to erectile dysfunction. However, not all beta-blockers and diuretics may not cause the condition and the occurrence of erectile dysfunction may vary from person to person.
Managing Erectile Dysfunction In Hypertension
- Reducing weight as obesity is directly linked to hypertension, which in turn, linked to erectile dysfunction.
- Quit smoking.
- Maintain an active lifestyle.
- Make changes in your diet. Introducing a Mediterranean diet is the best way as it has a lot of positive benefits. 
- A combination of exercise and diet can decrease around 30 per cent of the risk of the erectile dysfunction which is related to obesity. 
- If hypertension medications are leading to erectile dysfunction, consult your doctor for changes in medications or other ways to deal with it.
Erectile dysfunction can be challenging for hypertensive men in many ways. The stress due to both conditions can also lead to depression and relationship problems. However, with strict lifestyle management and proper medication, one can effectively treat or prevent the risk of erectile dysfunction, and also manage high blood pressure.
Hypertension may not always lead to erectile dysfunction, but studies say that around 30 per cent of hypertensive men may suffer from the erectile dysfunction due to certain factors like cellular dysfunction and usage of antihypertensive drugs. Other factors like smoking and alcohol consumption can also lead to hypertension-associated ED.
Though certain first class blood pressure medications like beta-blockers and diuretics can lead to erectile dysfunction or worsen it, other drugs like antagonists and inhibitors may help treat hypertension, and reduce risk of ED. However, not all beta-blockers and diuretics can cause ED and also, the effect of hypertension medications may vary from person to person.
Erectile dysfunction can be reversed if the homeostasis of the blood pressure is well-maintained in the penis, meaning the blood pressure should neither be too high nor too less. However, some blood pressure lowering medication can reverse erectile dysfunction in some ways.