Erectile Dysfunction as a Cardiovascular Risk Factor: Time to Step Up?

Abstract

Background: Erectile dysfunction (ED) is a major health problem that affects a significant proportion of the general population, and its prevalence is even higher in patients with CV risk factors and/or disease. ED and cardiovascular (CV) disease share several common pathophysiological mechanisms and thus, the potential role of ED as a predictor of CV events has emerged as a significant research aspect. Objective: The purpose of this review is to present and critically discuss data assessing the relation between ED and CV disease and the potential predictive value of ED for CV events. Method: A comprehensive review of the literature has been performed to identify studies evaluating the association between ED and CV disease. Results: Several cross-sectional and prospective studies have examined the association of ED and CV disease and found an increased prevalence of ED in patients with CV disease. ED was shown to independently predict future CV events. Importantly, ED was found to precede the development of overt coronary artery disease (CAD) by 3 to 5 years, offering a “time window” to properly manage these patients before the clinical manifestation of CAD. Phosphodiesterase type 5 inhibitors are the first line treatment for ED and were shown to be safe in terms of CV events in patients with and without CV disease. Conclusion: Accumulating evidence supports a strong predictive role of ED for CV events. Early identification of ED could allow for the optimal management of these patients to reduce the risk for a CV event to occur.

Shock Wave Therapy for Erectile Dysfunction: Marketing and Practice Trends in Major Metropolitan Areas in the United States

“…Per AUA guidelines, a diagnosis of ED in a patient should prompt a formal men's health evaluation, in part due to the demonstrable link between ED and later coronary events. 23,24 The findings here demonstrate that patients are seeking treatment for ED from providers who trained in dermatology, gynecology, physical medicine and rehabilitation, and chiropractic medicine, among others. As stewards of men's health, urologists are best positioned to take the lead on reaching and treating patients with ED.…”

Novel erectile analyses revealed augmentable penile Lyve‐1, the lymphatic marker, expression

“… 43 , 44 Although the association between diabetes mellitus and ED has been known for a long time, the relationship of lifestyle‐related diseases such as hypertension, hyperlipidemia and obesity to ED has received particular attention in recent years. 45 , 46 , 47 , 48 The treatment of ED improved significantly owing to PDE5 inhibitors, but a significant number of patients showed resistance to the treatment. 42 , 49 , 50 , 51 Therefore, it is essential to analyze the causes of such severe forms of ED cases and to evaluate penile blood vessels/flow.…”

A visualization system for erectile vascular dynamics

“…The disease has a significant impact on the quality of life and is an emerging public health problem. Since systemic vascular disease and ED share many common risk factors, it has been suggested that ED is an early marker for atherosclerosis, cardiovascular events, and asymptomatic systemic vascular diseases (Chien and Schwarz, 2007;Imprialos et al, 2021). Androgens play an important role in the maintenance of the erectile tissue structure, smooth muscle, and endothelium (Hyuga et al, 2019;Kajimoto et al, 2022;Ueda et al, 2022).…”