I am seeking to understand the pathophysiology linking hypertension and erectile dysfunction. Considering that adequate vascular function is essential for normal erectile physiology, elevated blood pressure may contribute to endothelial dysfunction, which in turn impairs nitric oxide bioavailability and vasodilation mechanisms. Could anyone provide insights into whether hypertension directly causes erectile dysfunction, or if it primarily acts as an indirect risk factor by exacerbating other underlying conditions such as atherosclerosis? Furthermore, I am interested in examining how different classes of antihypertensive agents might influence erectile function, as there appears to be variability in their vascular effects. Any empirical data or references to recent comparative studies would be appreciated.