Since the late 1980s a rapid increase in the number of prescriptions for the treatment and prevention of cardiovascular disease (CVD) began.
The class of antihypertensive agents is the second most commonly prescribed class of medication, exceeded only by antidepressants [
1]. In this time of high life expectancies, this therapy will be received during a substantial part of patients’ lives [
2]. The side effects induced by cardiovascular drugs are strongly associated with an impaired quality of life [
3], affecting both patients and their partners [
4]. Some classes of cardiovascular drugs have been described to cause sexual dysfunction. Diuretics and β-blockers can give rise to a decrease in libido, difficulty attaining or maintaining an erection and ejaculation problems [
5‐
7]. However, recent literature describes beneficial effects on sexual health for third-generation β-blockers [
8], angiotensin II receptor blockers (ARBs) [
9‐
12] and statins [
13]. Existing data of experimental, observational and clinical studies consistently point towards similar effects of antihypertensive drugs on male and female sexual function [
14‐
16]. As many as 70 % of hypertensive patients who experience side effects are non-compliant with their antihypertensive medication and have a 40 %–60 % higher rate of therapy discontinuation, compared with patients whose quality of life is unaffected [
17,
18]. Since non-adherence with antihypertensive therapy can be life threatening, it is of great importance for cardiologists to be aware of the side effects that may be caused by the drugs they prescribe, including effects on patients’ sexual function. Of course, cardiovascular drugs that improve symptoms and survival should not be withheld due to concerns about their potential impact on sexual function [
19]. But whenever possible, multiple alternative options are available in order to provide patient-centred care. These options are described in part II of this article, which will be published in a later issue of this journal. Information about cardiologists’ practice patterns concerning switches in medication, in order to improve patients’ sexual function, is not yet available. Neither is it known whether cardiologists are aware of the different effects of cardiac drugs on sexual function. However, cardiologists will only be able to provide medicinal therapy with an optimum balance between efficacy and quality of life and to provide patients with sufficient information regarding the prescribed therapy if they have knowledge about these effects.
A recent report from our group revealed that Dutch cardiologists did not routinely discuss sexual function and a considerable number (41.9 %) of the respondents indicated a need for training to increase their knowledge to be able to discuss sexual matters with patients [
20]. Accordingly, we hypothesised that information about the several effects of cardiovascular agents on sexual function has not yet permeated the cardiology practice. Therefore, aim of this study was to evaluate to what extent cardiologists are aware of the potential negative, neutral or beneficial effects that cardiovascular drugs can have on sexual function and whether this knowledge is actively used in patient care. We made use of additional data obtained during the National survey among cardiologists assessing their awareness, knowledge and practice patterns regarding sexual dysfunction in cardiac patients. Results of this survey, in combination with the review (part II), will provide cardiologists and residents in cardiology with the necessary information to be able to provide holistic healthcare.