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The assessment of vascular risk in men with erectile dysfunction: the role of the cardiologist and general physician
Article first published online: 28 MAY 2013
© 2013 John Wiley & Sons Ltd
International Journal of Clinical Practice
Volume 67, Issue 11, pages 1163–1172, November 2013
How to Cite
Jackson, G., Nehra, A., Miner, M., Billups, K. L., Burnett, A. L., Buvat, J., Carson, C. C., Cunningham, G., Goldstein, I., Guay, A. T., Hackett, G., Kloner, R. A., Kostis, J. B., Montorsi, P., Ramsey, M., Rosen, R., Sadovsky, R., Seftel, A. D., Shabsigh, R., Vlachopoulos, C. and Wu, F. C. W. (2013), The assessment of vascular risk in men with erectile dysfunction: the role of the cardiologist and general physician. International Journal of Clinical Practice, 67: 1163–1172. doi: 10.1111/ijcp.12200
- Issue published online: 24 OCT 2013
- Article first published online: 28 MAY 2013
- Manuscript Accepted: 23 APR 2013
- Manuscript Received: 27 SEP 2012
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.