Combined Antihypertensive Therapy and Sexual Dysfunction

• Female Sexual Function Index (FSFI) [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]
  The Female Sexual Function Index (FSFI) is a multidimensional self-report scale for assessing sexual function in women.The FSFI hase been validated in women with various sexual disorders,and in non-dysfunctional controls showing good discriminant validity,internal consistency,and test-retest reliability.
  
  
• International Index of Erectile Function(IIEF) [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]
  The 15-item International Index of Erectile Function (IIEF) was developed to diagnose the presence and severity of erectile dysfunction (ED).
  
  

• Change of Systolic Blood Pressure in 2 Weeks [ Time Frame: 2 weeks ] [ Designated as safety issue: No ]

  The decrease of systolic blood pressure compared with baseline. Baseline is blood pressure in 0 week.

  BP is measured using a calibrated standard mercury sphygmomanometer.After the patient has been seated for 15 minutes,sitting BP is measured 2 times at 1- to 2-minutes intervals,The mean of 2 sitting BP measurements is used as the sitting BP value for that visit;If the difference between the 2 measurements is over 5mmHg,BP should be measured again, and the average of 3 measurements will be taken.

  
  
• Change of Systolic Blood Pressure in 4 Weeks [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]
  The decrease of systolic blood pressure compared with baseline. Baseline is blood pressure in 0 week.
  
  
• Change of Systolic Blood Pressure in 8 Weeks [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  The decrease of systolic blood pressure compared with baseline. Baseline is blood pressure in 0 week.
  
  
• Change of Systolic Blood Pressure in 12 Weeks [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The decrease of systolic blood pressure compared with baseline. Baseline is blood pressure in 0 week
  
  
• Change of Systolic Blood Pressure in 24 Weeks [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  The decrease of systolic blood pressure compared with baseline. Baseline is blood pressure in 0 week.
  
  
• Change of Systolic Blood Pressure in 48 Weeks [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  The decrease of systolic blood pressure compared with baseline. Baseline is blood pressure in 0 week
  
  
• Change of Diastolic Blood Pressure in 2 Weeks [ Time Frame: 2 weeks ] [ Designated as safety issue: No ]
  The decrease of diastolic blood pressure compared with baseline. Baseline is blood pressure in 0 week
  
  
• Change of Diastolic Blood Pressure in 4 Weeks [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]
  The decrease of diastolic blood pressure compared with baseline. Baseline is blood pressure in 0 week
  
  
• Change of Diastolic Blood Pressure in 8 Weeks [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  The decrease of diastolic blood pressure compared with baseline. Baseline is blood pressure in 0 week
  
  
• Change of Diastolic Blood Pressure in 12 Weeks [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The decrease of diastolic blood pressure compared with baseline. Baseline is blood pressure in 0 week.
  
  
• Change of Diastolic Blood Pressure in 24 Weeks [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  The decrease of diastolic blood pressure compared with baseline. Baseline is blood pressure in 0 week.
  
  
• Change of Diastolic Blood Pressure in 48 Weeks [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  The decrease of diastolic blood pressure compared with baseline. Baseline is blood pressure in 0 week.
  
  
• Serum Estradiol in 24 Weeks [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  Fasting blood samples are taken at 8:00-10:00.After quiescence for 1h and centrifuged (3500rpm/min * 15min), serum samples are extracted and preserved in -80 ℃. Use hemiluminescent radioimmunoassay to detect the level of estradiol in serum sample.
  
  
• Serum Estradiol in 48 Weeks [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  
• Serum Testosterone in 24 Weeks [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  Fasting blood samples are taken at 8:00-10:00.After quiescence for 1h and centrifuged (3500rpm/min * 15min), serum samples are extracted and preserved in -80 ℃. Use hemiluminescent radioimmunoassay to detect the level of testosterone in serum sample.
  
  
• Serum Testosterone in 48 Weeks [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  
• Serum MDA in 24 Weeks [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

  Among many oxidative stress biological indicators,malondialdehyde (MDA),the secondary products of lipid peroxidation,is the most representative and most studied polyunsaturated fatty acid peroxidation.

  Fasting blood samples are taken at 8:00-10:00.After quiescence for 1h and centrifuged (3500rpm/min * 15min), serum samples are extracted and preserved in -80 ℃. Use ELISA to detect the level of MDA in serum samples.

  
  
• Serum MDA in 48 Weeks [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  
• Serum 8-OHdG in 24 Weeks [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

  Reactive oxygen species (ROS) produced either endogenously or exogenously can attack lipid, protein and nucleic acid simultaneously in the living cells. In nuclear and mitochondrial DNA, 8-hydroxydeoxyguanosine (8-OHdG) is produced during DNA repair and its measurement be useful as a marker of DNA lesion.

  Fasting blood samples are taken at 8:00-10:00.After quiescence for 1h and centrifuged (3500rpm/min * 15min), serum samples are extracted and preserved in -80 ℃. Use ELISA to detect the level of 8-OHdG in serum samples.

  
  
• Serum 8-OHdG in 48 Weeks [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  
• Serum HNE in 24 Weeks [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

  4 - hydroxy-nonyl acid (HNE) is a strong toxicity end product of lipid peroxidation.

  Fasting blood samples are taken at 8:00-10:00.After quiescence for 1h and centrifuged (3500rpm/min * 15min), serum samples are extracted and preserved in -80 ℃. Use ELISA to detect the level of HNE in serum samples.

  
  
• Serum HNE in 48 Weeks [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  

The effects of hypertension and its pharmacotherapy on sexual function are well known in men,although this topic remains unexplored in women.There is evidence suggests that some classes of antihypertensive drugs such as diuretics and beta-blockers have more negative impact on male sexual function than other classes such as calcium channel blockers(CCBs) and angiotensin-converting enzyme inhibitors(ACEI).Some data suggest that angiotensin Ⅱ antagonists（ARBs) not only do not exacerbate sexual function in males,but even improve it.

Treatment with multiple antihypertensive medications was often necessary to attain blood-pressure goals recommended by guidelines.More than two third of patients with 2 or 3 degree of essential hypertension require combination therapy at the beginning of treatment to avoid target organ damage and to minimize the accidence of adverse events.

CCBs were recommended by both JNC-7 and ESH / ESC 2007 hypertension guidelines as the basic for the treatment of hypertension.The purpose of this study is to compare the impacts of different CCB-based antihypertensive drugs combination on sexual behavior in both male and female patients with essential hypertension,thus provide evidences for physicians to increase patients adherence to the treatment regimens beside lowing blood pressure.