How to save a life during a clinic visit for erectile dysfunction by modifying cardiovascular risk factors

Abstract

Erectile dysfunction (ED) is an early marker for systemic atherosclerosis and is a predictor for coronary artery disease and cardiac events. The aim of this paper is to convey the importance of addressing cardiovascular risk factors in patients with ED and to inform urologists as well as other physicians who are not specialized in cardiology how to carry out a basic cardiovascular evaluation, including history, physical examination and objective data. We review the evidence and pathophysiology linking ED to cardiovascular disease, and then describe how to carry out a basic cardiovascular evaluation. We present data from the literature showing that appropriate use of lifestyle modifications and medical therapy has a positive effect on mortality, on numerous cardiovascular end points and on ED. Suggestions of when to refer the ED patient to an internist or cardiologist are provided. Identifying and treating cardiovascular risk factors may not only benefit the patient's ED, but it might also save the patient's life.

Connecting the Lines between Hypogonadism and Atherosclerosis

“…However, ED is also an early marker of generalized atherosclerosis and a predictor of cardiovascular events [104]. ED cannot be used as a surrogate end point for atherosclerosis in studies looking at testosterone, because the effect itself is confounded by the low testosterone levels.…”

Coronary Artery Bypass Surgery and Sexual Function

“…Nevertheless, some reports declared that CABS does not provide a net gain in SF (10,11). It should be kept in mind that ED may be early marker of CAD, and must prompt every physician to evaluate the patient for CAD (18). Although some previous reports in the literature commonly used the short form of IIEF questionnaire (IIEF-5) and analyzed only EF and/or had commonly no sufficient follow-up period, we used the full form of IIEF questionnaire and also evaluated all sexual components of the sample before and 6 months after CABS.…”

“…The prevalence of ED in general population is 19-52% (2,17). Atherosclerosis is the most common cause of ED, and the patients with CAD are commonly together with ED that occurs as a result of some potential mechanisms (2,18). ED has significant influences on quality of life.…”

“…This questionnaire consists of 15 questions to evaluate the subgroups of sexual function including total IIEF score, erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS) and overall satisfaction (OS). Scoring the IIEF domain of erectile function provides the classification of each patient as having no (26)(27)(28)(29)(30), mild (17)(18)(19)(20)(21)(22)(23)(24)(25), moderate (11)(12)(13)(14)(15)(16) or severe (0-10) ED. As a result of this evaluation, we have determined the preoperative status of EF and other subgroups of SF in IIEF questionnaire.…”

Circulating matrix metalloproteinases and their endogenous inhibitors in patients with erectile dysfunction

“…[1][2][3] Indeed, ED shares many risk factors with cardiovascular diseases [4][5][6][7] and it may be an early manifestation of vascular dysfunction, 8 and possibly a clinical marker for cardiovascular diseases. 2,9 Moreover, ED is very common among men with diabetes mellitus (DM), [4][5][6]10,11 in whom the prevalence has been reported to vary from 20-71%. 10 Recent studies have implicated matrix metalloproteinases (MMPs) as key players in the functional and structural cardiovascular alterations associated with hypertension [12][13][14][15] and with other cardiovascular diseases.…”