All men with vasculogenic erectile dysfunction require a cardiovascular workup.
Authors:Martin Miner|||Ajay Nehra|||Graham Jackson|||Shalender Bhasin|||Kevin Billups|||Arthur L Burnett|||Jacques Buvat|||Culley Carson|||Glenn Cunningham|||Peter Ganz|||Irwin Goldstein|||Andre Guay|||Geoff Hackett|||Robert A Kloner|||John B Kostis|||K Elizabeth LaFlamme|||Piero Montorsi|||Melinda Ramsey|||Raymond Rosen|||Richard Sadovsky|||Allen Seftel|||Ridwan Shabsigh|||Charalambos Vlachopoulos|||Frederick Wu
Journal: The American journal of medicine
Publication Type: Journal Article
Date: 2014
DOI: 10.1016/j.amjmed.2013.10.013
ID: 24423973
Affiliations:
Affiliations
Departments of Family Medicine and Urology, Miriam Hospital and Brown University, Providence, RI. Electronic address: martin_miner@brown.edu.|||Department of Urology, Rush University, Chicago, Ill.|||Guy's & St. Thomas Hospital, London, UK.|||Department of Medicine, Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Mass.|||Department of Urologic Surgery, University of Minnesota, Minneapolis; The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Md.|||The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Md.|||Centre d'Etude et de Traitement de la Pathologie de l'Appareil Reproducteur et de la Psychosomatique, Lille, France.|||Department of Surgery, Division of Urologic Surgery, University of North Carolina, Chapel Hill.|||Departments of Medicine, and Molecular & Cellular Biology, Baylor College of Medicine and St. Luke's Episcopal Hospital, Houston, Tex.|||Division of Cardiology, San Francisco General Hospital and University of California, San Francisco, Calif.|||San Diego Sexual Medicine, Calif.|||Center For Sexual Function/Endocrinology, Lahey Clinic Medical Center, Peabody, Mass, Tufts University School of Medicine, Boston, Mass.|||Good Hope Hospital, Birmingham, UK.|||Heart Institute, Good Samaritan Hospital and Keck School of Medicine at University of Southern California, Los Angeles.|||Cardiovascular Institute, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ.|||Complete Healthcare Communications, Inc., Chadds Ford, Pa.|||Centro Cardiologico Monzino, IRCCS, Institute of Cardiology University of Milan, Italy.|||Complete Healthcare Communications, Inc., Chadds Ford, Pa.|||New England Research Institutes, Inc., Watertown, Mass.|||Department of Family Medicine, SUNY-Downstate Medical Center, Brooklyn, NY.|||Department of Urology, Cooper University Hospital, Camden, NJ.|||Division of Urology, Maimonides Medical Center, Brooklyn, NY, and College of Physicians and Surgeons of Columbia University, New York, NY.|||1st Department of Cardiology, Athens Medical School, Athens, Greece.|||Andrology Research Unit, Developmental & Regenerative Biomedicine Research Group, University of Manchester, Manchester Academic Health Science Centre, Manchester Royal Infirmary, UK.
Abstract
An association between erectile dysfunction and cardiovascular disease has long been recognized, and studies suggest that erectile dysfunction is an independent marker of cardiovascular disease risk. Therefore, assessment and management of erectile dysfunction may help identify and reduce the risk of future cardiovascular events, particularly in younger men. The initial erectile dysfunction evaluation should distinguish between predominantly vasculogenic erectile dysfunction and erectile dysfunction of other etiologies. For men believed to have predominantly vasculogenic erectile dysfunction, we recommend that initial cardiovascular risk stratification be based on the Framingham Risk Score. Management of men with erectile dysfunction who are at low risk for cardiovascular disease should focus on risk-factor control; men at high risk, including those with cardiovascular symptoms, should be referred to a cardiologist. Intermediate-risk men should undergo noninvasive evaluation for subclinical atherosclerosis. A growing body of evidence supports the use of emerging prognostic markers to further understand cardiovascular risk in men with erectile dysfunction, but few markers have been prospectively evaluated in this population. In conclusion, we support cardiovascular risk stratification and risk-factor management in all men with vasculogenic erectile dysfunction.
