Erectile dysfunction: A hidden epidemic (original) (raw)
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The Association of Erectile Dysfunction and Cardiovascular Disease: A Systematic Critical Review
American journal of men's health, 2016
Despite strong association between erectile dysfunction (ED) and cardiovascular disease (CVD), there is a paucity of clear clinical guidelines detailing when and how to evaluate for ED in patients with known CVD, or vice versa. This systematic review discuss the role of cardiologists and urologists in the characterization of risk and management of CVD in the setting of ED, as well as contrasting the current evaluation of CVD and ED from the standpoint of published consensus statements. A comprehensive literature review utilizing MEDLINE®, the Cochrane Library® Central Search, and the Web of Science was performed to identify all published peer-reviewed articles in the English language describing ED and CVD across various disciplines. There is strong consensus that men with ED should be considered at high risk of CVD. Available risk assessment tools should be used to stratify the coronary risk score in each patient. The 2012 Princeton III Consensus Conference expanded on existing card...
European Journal of Preventive Cardiology, 2017
Aims Erectile dysfunction is associated with increased risk of cardiovascular disease; however, little is known about patients seeking treatment for erectile dysfunction. This study investigated the risk of cardiovascular disease for patients receiving medication for erectile dysfunction. Methods and results This nationwide cohort study included 71,710 men aged 40–80 years receiving their first erectile dysfunction medication from 2000 to 2012. Their adjusted risk of cardiovascular events in time intervals after the first erectile dysfunction medication was compared to the general male population using multivariate Poisson regression models and was expressed as a risk ratio (RR). The risk for overall cardiovascular disease was decreased in the first 3 years: the RR in the first year was 0.92 (95% confidence interval [CI] 0.87–0.97, p = 0.003; incidence: 23.68 per 1000 patient-years), and after 1–3 years the RR was 0.94 (95% CI 0.90–0.97, p = 0.002; incidence: 24.92 per 1000 patient-...
Incidence of Primary Cardiovascular Risk Factors in Patients with Erectile Dysfunction
2018
Aim: Identification of primary cardiovascular risk factors in patients with erectile dysfunction. Material and methods: The study included 308 apparently healthy men, with a mean age of 45±12.1 years. The Sexual Health Inventory for Men (SHIM) questionnaire was used to determine the following indices: BMI, blood pressure, blood glucose, cholesterol, triglycerides, etc. Results: The total incidence of cardiovascular risk factors was 56%: 45% in men aged up to 40 years (group I) and 74% in those over 40 years (group II). High blood pressure was found in 9% of the men in group I and 55% in those in group II (p <0.05). Blood glucose levels were recorded in 5% of group I patients 24% in group II patients. Sixty-six percent of the men over 40 years were overweight compared with 16% of men under age 40. Dyslipidemia was present in 65% of group I versus 19% in group II. Conclusions: Our study shows that especially in men over 40 years of age erectile dysfunction is a vascular endothelial...
A multidisciplinary approach to assess erectile dysfunction in high-risk cardiovascular patients
International Journal of Impotence Research, 2005
Erectile dysfunction (ED) is increasingly considered as one manifestation of systemic vascular disease. Accordingly, ED and coronary artery disease share mutual risk factors and frequently coexist. Sexual health is an important aspect of our patients' lives, and ED is a common concern of the cardiovascular patient. Despite this, sexual function is under-addressed in the cardiac patient. Even when this topic is broached by the primary care physician or urologist, ED frequently remains untreated due to safety concerns involving cardiac disease and other comorbidities. This article describes our experience with this unique patient population, as well as our approach to building a multidisciplinary clinic designed to specifically address the important issue of ED in the cardiac patient.
International Journal of Clinical Practice, 2013
Erectile dysfunction (ED) and cardiovascular disease (CVD) share risk factors and frequently coexist, with endothelial dysfunction believed to be the pathophysiologic link. ED is common, affecting more than 70% of men with known CVD. In addition, clinical studies have demonstrated that ED in men with no known CVD often precedes a CVD event by 2-5 years. ED severity has been correlated with increasing plaque burden in patients with coronary artery disease. ED is an independent marker of increased CVD risk including all-cause and especially CVD mortality, particularly in men aged 30-60 years. Thus, ED identifies a window of opportunity for CVD risk mitigation. We recommend that a thorough history, physical exam (including visceral adiposity), assessment of ED severity and duration and evaluation including fasting plasma glucose, lipids, resting electrocardiogram, family history, lifestyle factors, serum creatinine (estimated glomerular filtration rate) and albumin: creatinine ratio, and determination of the presence or absence of the metabolic syndrome be performed to characterise cardiovascular risk in all men with ED. Assessment of testosterone levels should also be considered and biomarkers may help to further quantify risk, even though their roles in development of CVD have not been firmly established. Finally, we recommend that a question about ED be included in assessment of CVD risk in all men and be added to CVD risk assessment guidelines. Review criteria We performed a PubMed search for articles pertinent to relationships between erectile dysfunction (ED) and cardiovascular disease (CVD), peripheral arterial disease, stroke, cardiovascular mortality, or all-cause mortality. The evidence-based consensus presented incorporates these articles, published guidelines and the expertise of the multi-specialty author group. Message for the clinic Erectile dysfunction is an independent marker of increased CVD risk, particularly in younger and middle-aged men. A cardiologist or other clinician with relevant expertise plays an important role in evaluating this risk in men with ED, who may have subclinical CVD. Increased recognition of the potential for CVD in men with ED, followed by appropriate preventive or corrective action, can improve and may save lives.
Erectile dysfunction as a harbinger for increased cardiometabolic risk
International Journal of Impotence Research, 2008
In August 2003, the Minority Health Institute (MHI) convened an Expert Advisory Panel of cardiologists and urologists to design a new practice model algorithm that uses erectile dysfunction (ED) as a clinical tool for early identification of men with systemic vascular disease. The MHI algorithm noted ED as a marker for the presence of cardiovascular disease and suggested that ED may well be a cardiovascular risk equivalent warranting aggressive secondary prevention management strategies, even in the absence of other cardiac or peripheral vascular symptoms. The MHI algorithm stipulates that all men 25 years of age and older should be asked about ED as a routine part of the cardiovascular history during any office visit. The presence of ED should prompt an aggressive assessment for occult vascular disease; many men with erectile difficulty would benefit from early, aggressive management of cardiovascular risk factors with both lifestyle modification and pharmacotherapy to achieve optimal target goals under the existing treatment guidelines. Since publication of the algorithm in 2005, additional research studies have further supported the advisory panel recommendations.
Revista Portuguesa de Saúde Pública, 2016
Introduction: Erectile dysfunction (ED) inquiry and treatment could have an important role in cardiovascular prevention. The aims of the present study were to: (1) evaluate the association of ED with cardiovascular risk (CVR) factors among patients with no previous cardiovascular events; (2) assess the inquiry of ED in Portuguese primary care. Methods: Cross-sectional study (January-March 2011) conducted in two Lisbon Primary Healthcare Centers among men aged 18-80 years, sexually active and with no cardiac or cerebrovascular disease. We collected data concerning CVR factors and sexual health inquiry through interviews and clinical records and we used the International Index of Erectile Function to evaluate ED. Logistic regression models were used to study the association between ED and CVR factors. Results: In a sample of 90 men (mean age 49.82 ± 15.65), 32% had ED. Hypertension prevalence and the number of CVR factors was significantly higher among men with ED. However, age was strongly associated with ED and, after age-adjustment, the associations found between ED and hypertension lost their statistical significance. The majority of men evaluated their sexual life as "very important" or "important" (98%) and affirmed that sexual problems should be inquired by the general practitioner (93%) but only a minority were inquired about it (14%). Conclusion: ED is a frequent problem among men with no previous cardiovascular events and, in our study, it was mostly associated with age. ED is still not inquired appropriately in the primary care.
Association Between Erectile Dysfunction and Cardiovascular Disease: A Systematic Review
Chattagram Maa-O-Shishu Hospital Medical College Journal
Erectile Dysfunction (ED) describes the persistent inability to achieve or maintain a penile erection for adequate sexual performance. ED is thought to be a vascular disease affecting more than 70% of men with (Cardiovascular Disease) CVD and sharing a myriad of risk factors like hypertension, smoking, diabetes, obesity, ageing and the metabolic syndrome. Diabetes increases the risk of both ED and CVD with the latter being the leading cause of death. Endothelial dysfunction and its role in the development of atherosclerosis may be the common link between ED, CVD and diabetes. With the current epidemic of type 2 diabetes, diabetes related CVD will increase in tandem. Early identification of this risk group is therefore paramount. Evidence has shown that ED is an independent marker of increased CVD risk and heralds the onset of coronary artery disease, peripheral arterial disease and stroke thereby providing a window of opportunity for risk factor modification. In our paper we shall e...