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Erectile Dysfunction Is a Hallmark of Cardiovascular Disease: Unavoidable Matter of Fact or Opportunity to Improve
Dimitri Yannas1,2, Francesca Frizza3, Linda Vignozzi1,2
1Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50121-50145 Florence, Italy.
Insights
Erectile dysfunction (ED) is an early sign of cardiovascular disease (CVD). Recognizing both traditional and unconventional risk factors in men with ED helps predict and prevent major adverse cardiovascular events (MACE).
Area of Science:
- Cardiology
- Urology
- Men's Health
Background:
- Erectile dysfunction (ED) often precedes the clinical manifestation of cardiovascular (CV) disease.
- A significant number of major adverse CV events (MACE) occur in individuals without traditional CV risk factors.
- Assessing men with ED for both traditional and unconventional risk factors is crucial for CV risk stratification.
Purpose of the Study:
- To highlight the importance of comprehensive CV risk assessment in men with ED.
- To identify traditional and unconventional risk factors that predict MACE in men with ED.
- To emphasize the role of risk factor modification in reducing CV risk and improving erectile function.
Main Methods:
- Review of clinical assessment parameters in men with ED.
- Identification of parameters that serve as predictors of MACE.
- Analysis of the impact of risk factor correction on CV risk and erectile function.
Main Results:
- ED is an early indicator of underlying CV disease.
- Unconventional risk factors, alongside traditional ones, are valuable predictors of MACE in men with ED.
- Parameters like family history, alcohol abuse, obesity, and impaired penile blood flow are significant predictors.
- Correction of identified risk factors can reduce CV risk and improve erectile function.
Conclusions:
- Men with ED require thorough CV risk assessment, including unconventional factors.
- Early identification and management of these risk factors are essential for preventing MACE.
- Interventions targeting risk factors in men with ED can yield dual benefits for cardiovascular health and erectile function.
Abstract:
Erectile dysfunction (ED) is an early manifestation of cardiovascular (CV) disease. For this reason, men with ED should be carefully assessed for CV risk factors in order to prevent future major adverse CV events (MACE). Traditional risk factors are not found in all subjects at high CV risk. In fact, a relevant proportion of MACE occurs in men who are apparently risk factor free. In men with ED, it is important to take into account not only traditional risk factors but also unconventional ones. Several parameters that derive from good clinical assessment of subjects with ED have proven to be valuable predictors of MACE. These include family history of cardiometabolic events, alcohol abuse, fatherhood, decreased partner's sexual interest, severe impairment in erection during intercourse or during masturbation, impaired fasting glucose, increased triglycerides, obesity even without metabolic complications, decreased penile blood flows or impaired response to an intra-cavernosal injection test. Recognizing these risk factors may help in identifying, among subjects with ED, those who merit stricter lifestyle or pharmacological interventions to minimize their CV risk. Effective correction of risk factors in ED men considered as high risk, besides reducing CV risk, is also able to improve erectile function.
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