Abstract

Background: Erectile dysfunction (ED) has a variety of causes. Certain antihypertensive medications usage is known to exacerbate and increase the risk of ED. One type of antihypertensive agent associated with a greater risk of ED is beta-blockers. Among the available options of beta-blocker, further comparison needs to be done to evaluate which beta-blocker has a lower risk of ED. Objective: This study aimed to assess which beta-blocker has a lower risk of ED. Methods: Search for published articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on PubMed, Cochrane Library, and Medline databases published in the last 20 years on “beta-blocker” and “erectile dysfunction”. Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published articles. Results: Based on 6 studies included with total of 1578 participants, 5 kinds of beta-blocker used on the participants include atenolol (17,8%), bisoprolol (31,1%), carvedilol (10,8%), metoprolol (9,8%), and nebivolol (30,5%). Nebivolol (RR = 0.87: 95% CI: 0.79-0.95) found to has the lowest risk ratio compared with another beta-blocker such as carvedilol (RR = 1.00: 95% CI: 0.92-1.09), metoprolol (RR = 1.05: 95% CI: 0.94-1.17), atenolol (RR = 1.07: 95% CI: 0.98-1.16), and bisoprolol (RR = 1.37: 95% CI: 1.01-1.87). Conclusions: Nebivolol is a beta-blocker option recommended to avoid ED because of its lower risk of ED compared with other beta-blockers. Bisoprolol was found to be associated with a higher risk of ED, followed by atenolol, metoprolol, and carvedilol, respectively.

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