Erectile Function in Cardiovascular Disease and Hypertension: the Role of Nebivolol

Beta blockers are used for the management of arterial hypertension and are gold standard treatment for coronary artery disease and heart failure, medical conditions that affect large numbers of older patients and are associated with very high morbidity and mortality rates. Lifelong therapy in primary and secondary prevention (without and with established cardiovascular disease, respectively) is limited by low adherence to drugs which is accompanied by increased mortality. Drug adverse events and impaired quality of life are among the main causes of poor adherence to therapy. Erectile dysfunction is the ‘prima ballerina’ of drug-induced life quality impairment. Beta blockers exert detrimental effects on erectile function. In contrast, nebivolol (a third generation beta blocker with vasodilating properties and proven efficacy in patients with hypertension and heart failure) does not share the unfavourable effects of other beta blockers on erectile function due to increased nitric oxide bioavailability. Therefore, Nebivolol represents an attractive option for patients with hypertension, heart failure, and other related diseases who need to be treated with beta blockers.