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. 2017 Dec;9(4):305-312.
doi: 10.1007/s11930-017-0137-y. Epub 2017 Oct 23.

Vascular Erectile Dysfunction and Subclinical Cardiovascular Disease

Zain Gowani  1 , S M Iftekhar Uddin  2 , Mohammadhassan Mirbolouk  2 , Dawar Ayyaz  2 , Kevin L Billups  3 , Martin Miner  4 , David I Feldman  2   5 , Michael J Blaha  2
Affiliations

Vascular Erectile Dysfunction and Subclinical Cardiovascular Disease

Zain Gowani et al. Curr Sex Health Rep. 2017 Dec.

Abstract

Purpose of review: We review the recent literature on the hypothesized temporal relationship between subclinical cardiovascular disease (CVD), vascular erectile dysfunction (ED), and clinical CVD. In addition, we combine emerging research with expert consensus guidelines such as The Princeton Consensus III to provide a preventive cardiologist's perspective toward an ideal approach to evaluating and managing CVD and ED risk in patients.

Recent findings: Development of ED was found to occur during the progression from subclinical CVD to clinical CVD. A strong association was observed between subclinical CVD as assessed by coronary artery calcium (CAC) and carotid plaque and subsequent ED, providing evidence for the role of subclinical CVD in predicting ED. ED is also identified as a substantial independent risk factor for overt clinical CVD, and ED symptoms may precede CVD symptoms by 2-3 years.

Summary: Given the body of evidence on the relationship between subclinical CVD, ED, and clinical CVD we recommend that all men with vascular ED should undergo cardiovascular risk assessment. We further recommend using CAC scores for advanced risk assessment in patients at low-intermediate to intermediate risk (5-20% CVD risk), with risk driving subsequent lifestyle and pharmacologic treatment decisions.

Keywords: Princeton III Consensus; cardiovascular disease; coronary calcium score; erectile dysfunction; risk assessment; subclinical disease.

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Conflict of interest statement

Conflict of Interest Zain Gowani, S M Iftekhar Uddin, Mohammadhassan Mirbolouk, Dawar Ayyaz, Kevin L. Billups, Martin Miner, David I. Feldman each declare no potential conflicts of interest. Michael J. Blaha reports grants from NIH, AHA, grants and personal fees from FDA, grants and personal fees from Amgen, grants from Aetna Foundation, personal fees from Novartis, personal fees from Siemens, personal fees from MedImmune, personal fees from Akcea, personal fees from Sanofi, personal fees from Regeneron outside the submitted work.

Figures

Figure 1
Figure 1. Relationship between ED and Subclinical Vascular Disease
Feldman et al., 2017 (A) Odds ratios for ED, by subclinical disease domain. Adjusted for: age, race, smoking, family history, log triglycerides, LDL, HDL, beta blockers, CES-D, education, BMI, waist circumference, TCA medications, non-TCA medications, anti-psychotic medication, systolic and diastolic blood pressure, hypertension medication, diabetes, hyperlipidemia, lipid-lowering therapy. (B) Frequency of ED among patients with different number of vascular abnormalities (C) Odds ratios for ED in patients with different number of vascular abnormalities
See this image and copyright information in PMC

References

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