A 58-y-old male visits his physician clinic with the complaint of erectile dysfunction (ED) for about one year. The man is overweight and has H/o hypertension, treated with a thiazide diuretic and calcium channel blocker for five years.
He has been an acute smoker for the past 30 years. He does not exercise and seldom notes cramps in his legs. His heart rate is 80 beats/min, and his BP is 138/86 mmHg; Lungs reveal scattered Bronchi and wheezes consistent with chronic obstructive lung disease. Routine laboratory reports indicate the HBA1C level as 8.6%. His lipid profile was regular, and eye examination showed mild arteriolar narrowing.
The physician advises the patient to increase physical activity such as exercise and quit smoking to relieve ED. The patient cannot be prescribed PDE5 inhibitors as he has higher risk factors such as CVD. The physician switches the patient from thiazide diuretics to the ACE inhibitor for hypertension management.
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