Management of sexual dysfunction in patients with cardiovascular disease: recommendations of the Princeton consensus panel

DeBusk, Robert F.; Drory, Yaacov; Goldstein, Irwin; Jackson, Graham; Kaul, Sanjay; Kimmel, Stephen E.; Kostis, John B.; Kloner, Robert A.; Lakin, Milton M.; Meston, Cindy M.; Mittleman, Murray A.; Muller, James E.; Padma‐Nathan, Harin; Rosen, Raymond C.; Stein, Richard A.; Zusman, Randall M.

doi:10.1016/s0002-9149(00)00896-1

Cited by 317 publications

(199 citation statements)

References 16 publications

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“…Completing 4 minutes of the standard Bruce treadmill protocol (5-6 Mets) without symptoms, arrhythmias, or a fall in systolic BP identifies the safety of sexual activity. 1,2,6 Based on stress test results, they will be reassigned to low-or high-risk groups as recommended after the first and second Princeton Consensus Conferences. Chemical stress tests (eg, dipyridamole or adenosine with nuclear imaging) are appropriate if the patient cannot complete a standard exercise test (eg, owing to a disabling condition such as arthritis).…”

Section: Mayo Clinic Proceedingsmentioning

confidence: 99%

“…1,2 Briefly, an international panel of 22 experts provided state-of-the-art presentations pertaining to the epidemiologic and physiologic links among hypogonadism, ED, and CVD; benefits and risks of testosterone depletion and repletion; evaluation of traditional and emerging cardiometabolic risk factors and assessment tools; and available treatments for ED. After the presentations, a representative consensus panel met to review the information and, based on available scientific evidence, to develop recommendations for clinical practice and further research.…”

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confidence: 99%

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The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Nehra

Jackson

Miner

et al. 2012

Mayo Clinic Proceedings

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The Princeton Consensus (Expert Panel) Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The third Princeton Consensus met November 8 to 10, 2010, and had 2 primary objectives. The first objective focused on the evaluation and management of cardiovascular risk in men with erectile dysfunction (ED) and no known cardiovascular disease (CVD), with particular emphasis on identification of men with ED who may require additional cardiologic work-up. The second objective focused on reevaluation and modification of previous recommendations for evaluation of cardiac risk associated with sexual activity in men with known CVD. The Panel's recommendations build on those developed during the first and second Princeton Consensus Conferences, first emphasizing the use of exercise ability and stress testing to ensure that each man's cardiovascular health is consistent with the physical demands of sexual activity before prescribing treatment for ED, and second highlighting the link between ED and CVD, which may be asymptomatic and may benefit from cardiovascular risk reduction. T he Princeton Consensus Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The first conference convened in June 1999 to develop recommendations for clinical management of sexual dysfunction in men and women with known cardiovascular disease (CVD). This conference also provided a multidisciplinary forum for evaluation of the potential cardiovascular risk posed by sexual activity in atrisk patients. The first Princeton Consensus Conference recommendations 1 included stratification of patients by level of cardiac risk associated with sexual activity based on existing CVD. Those at low risk could initiate or resume sexual activity and be treated for sexual dysfunction. For those at high risk, sexual activity was deferred until the cardiac condition was stabilized. The second Princeton Consensus Conference convened in June 2004 and expanded the recommendations of the first conference to emphasize risk factor evaluation and lifestyle management for all men with erectile dysfunction (ED). 2 The second conference recommendations also incorporated new information on the appropriate use of phosphodiesterase type 5 (PDE5) inhibitors in men with ED and concomitant CVD.The third Princeton Consensus Conference took place November 8 to 10, 2010, in Miami Beach, Florida. The group revisited and updated their 2005 recommendations regarding the cardiovascular risk associated with sexual activity in men with known CVD. 2 In addition, the third conference focused on the predictive value of vasculogenic ED in assigning cardiovascular risk in men of all ages, with the primary objective being development of an approach to cardiovascular risk assessment in younger men with ED and no known CVD. The role of testosterone in erectile function and cardiovascular health and the utility of testosterone replacement...

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Section: Mayo Clinic Proceedingsmentioning

confidence: 99%

mentioning

confidence: 99%

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Nehra

Jackson

Miner

et al. 2012

Mayo Clinic Proceedings

Self Cite

420

341

View full text Add to dashboard Cite

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“…During intercourse with a familiar partner in comfortable surroundings, heart rate and blood pressure seldom exceed 130 beats/min and 170 mmHg, respectively. 6 Physical exertion is typically measured by the metabolic equivalent task (MET) of energy expenditure at the resting state. One MET is associated with an energy demand involving oxygen consumption of about 3.5 ml/kg/min.…”

Section: Sexual Activity and Cardiac Riskmentioning

confidence: 99%

“…There is one caveat, although not a major one: the sympathetic activation that occurs during sex can cause heart rate and blood pressure to increase more than it does during regular exercise of the same MET intensity. 6 The risk of cardiac events during intercourse or other types of sexual activity is very low, but is increased over that which occurs at rest. Among the general population, < 1% of myocardial infarctions (MIs) occur during intercourse, and the baseline annual risk of MI for a 50-year-old man living in the United States is about 1%.…”

Section: Sexual Activity and Cardiac Riskmentioning

confidence: 99%

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Cardiovascular risk stratification and cardiovascular risk factors associated with erectile dysfunction: Assessing cardiovascular risk in men with erectile dysfunction

Barrett‐Connor

2004

Clin Cardiol

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Summary: Cardiovascular risk factors are known to be associated with the presence of erectile dysfunction (ED), and ED is more common in men with cardiovascular disease (CVD). The Princeton Guidelines provide a strategy for assessing cardiac risk and planning a safe return to sexual activity. Men at low risk, who have fewer than three cardiac risk factors, can resume intercourse with very little concern for an untoward cardiac event. Men at high risk need to have their primary disease controlled, and should be stabilized before planning to resume sexual activity. Prior to resuming intercourse, men in the indeterminate category are candidates for restratification as either low or high risk. Certain cardiovascular risk factors may be predictors of ED: most notably, hyperlipidemia, hypertension, and diabetes. Advancing age is also a strong predictor of ED. The close correlation between ED and CVD is a signal to evaluate the sexual histories of all men who present for cardiovascular evaluation and, perhaps, of all men in general. Early detection of ED may allow for early diagnosis and management of CVD and diabetes.

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Sexual Activity in Patients With Angina

DeBusk¹

2003

JAMA

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Management of sexual dysfunction in patients with cardiovascular disease: recommendations of the Princeton consensus panel

Cited by 317 publications

References 16 publications

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Cardiovascular risk stratification and cardiovascular risk factors associated with erectile dysfunction: Assessing cardiovascular risk in men with erectile dysfunction

Sexual Activity in Patients With Angina

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