Prevalence and factors associated with erectile dysfunction among male hypertensive patients attending Mulago hospital hypertension clinic.

Abstract

Background: Uganda has a high prevalence of patients with hypertension with majority of the patients unaware of their condition and thus likely to present late with complications such as ED. Erectile dysfunction is common in hypertension and is associated with poor quality of life, erratic drug adherence, and has been known to predict poor disease outcome. Out of fear of embarrassment most patients with ED don’t report their problem to their attending physicians. In Uganda, Medical practitioners also often don’t routinely screen for ED in part due to the lack of awareness about the magnitude of the problem. The objectives of this study were to determine (a) the prevalence and (b) the factors associated with ED among male hypertensive patients attending Mulago hospital hypertension clinic. Methods: This was a cross section study design where 330 participants were recruited from Mulago Hospital Hypertension clinic. A structured questionnaire was used to collect participants’ demographic, hypertension and medication history. A self-reporting questionnaire (SRQ-20) was used to screen for depressive symptoms while the international index of erectile function-5(IIEF-5) was used to assess for ED. The participants were screened for diabetes mellitus/impaired glucose tolerance using HBA1C and hyperlipidaemia using Non HDLcholesterol. Using multivariate logistic regression, the factors that were independently associated with ED were determined. Results: The mean age of the study participants was 57±14.2 years. Most of them were known hypertensives without DM (59.4%). More than half had hyperlipidaemia (55.8%) and 51.2% had depressive symptoms. We found an overall prevalence of ED of 81.2% (95% CI: 76.6-85.3) among the study participants. Slightly more than a quarter of those with ED 25.1% (83/330) had mild ED, followed by 22.1% (73/330) who had severe ED. With multivariate logistic regression, increasing age (AOR=1.03:95%CI: 1.0, 1.1) and depressive symptoms (AOR=5.48:95%CI: 2.7, 11.1), were independently associated with ED. Conclusion: Erectile dysfunction is common among male hypertensive patients attending Mulago Hospital Hypertension clinic and is independently associated with increasing age and having depressive symptoms. Recommendation: All adult male hypertensive patients should be screened for ED at every hospital visit and appropriate management options recommended.