Diagnostic and Therapeutic Implications of Erectile Dysfunction in Patients with Cardiovascular Disease

Research output: Contribution to journalArticle

Abstract

Erectile dysfunction (ED) and cardiovascular disease (CVD) share many common pathophysiologic pathways and might be regarded as two different clinical manifestations of the same systemic disease. Consequently, ED and CVD are pathologic conditions that often coexist in the same patient. The urologist plays an important role in the management of ED in patients with a history of cardiovascular events. Therapeutic measures aimed at improving sexual function in CVD patients should be considered only after careful evaluation of the underlying cardiologic condition and assessment of ability to exercise. Sexual activity and treatment of ED might trigger cardiac events in selected patients with preexisting CVD; therefore, proerectile therapies should be administered only to low-risk patients for whom subsequent risk of cardiac events would not be increased. Conversely, men at high risk of CVD should receive cardiologic reassessment and stabilization before attempting sexual activity and receiving ED treatment. Risk reduction and lifestyle changes, administration of phosphodiesterase type 5 inhibitors, and testosterone replacement therapy, as indicated, might provide benefits not only in terms of improving sexual function but also for reducing the risk of future cardiac events. Patient summary: Erectile dysfunction (ED) and cardiovascular disease (CVD) share many pathophysiologic mechanisms and often coexist in the same patient. We evaluated the role of the urologist in the management of ED in patients with preexisting CVD and the impact of measures aimed at improving sexual function on the subsequent risk of cardiac events. The evaluation of the cardiovascular risk associated with sexual activity is mandatory before considering proerectile measures. Only patients at low risk can safely perform sexual activity and receive therapies aimed at improving their sexual function. Risk reduction and lifestyle change, the administration of phosphodiesterase type 5 inhibitors, and testosterone replacement therapy might have a beneficial effect both on erectile function and the risk of novel cardiac events.

Original languageEnglish
JournalEuropean Urology
DOIs
Publication statusAccepted/In press - 2016

Fingerprint

Erectile Dysfunction
Cardiovascular Diseases
Sexual Behavior
Phosphodiesterase 5 Inhibitors
Preexisting Condition Coverage
Therapeutics
Risk Reduction Behavior
Testosterone
Aptitude
Exercise

Keywords

  • Cardiovascular events
  • Cardiovascular mortality
  • Coronary artery disease
  • Erectile dysfunction
  • Phosphodiesterase type 5 inhibitors

ASJC Scopus subject areas

  • Urology

Cite this

@article{d8ef0070644d4ae6ad2b1029e3ec8dbd,
title = "Diagnostic and Therapeutic Implications of Erectile Dysfunction in Patients with Cardiovascular Disease",
abstract = "Erectile dysfunction (ED) and cardiovascular disease (CVD) share many common pathophysiologic pathways and might be regarded as two different clinical manifestations of the same systemic disease. Consequently, ED and CVD are pathologic conditions that often coexist in the same patient. The urologist plays an important role in the management of ED in patients with a history of cardiovascular events. Therapeutic measures aimed at improving sexual function in CVD patients should be considered only after careful evaluation of the underlying cardiologic condition and assessment of ability to exercise. Sexual activity and treatment of ED might trigger cardiac events in selected patients with preexisting CVD; therefore, proerectile therapies should be administered only to low-risk patients for whom subsequent risk of cardiac events would not be increased. Conversely, men at high risk of CVD should receive cardiologic reassessment and stabilization before attempting sexual activity and receiving ED treatment. Risk reduction and lifestyle changes, administration of phosphodiesterase type 5 inhibitors, and testosterone replacement therapy, as indicated, might provide benefits not only in terms of improving sexual function but also for reducing the risk of future cardiac events. Patient summary: Erectile dysfunction (ED) and cardiovascular disease (CVD) share many pathophysiologic mechanisms and often coexist in the same patient. We evaluated the role of the urologist in the management of ED in patients with preexisting CVD and the impact of measures aimed at improving sexual function on the subsequent risk of cardiac events. The evaluation of the cardiovascular risk associated with sexual activity is mandatory before considering proerectile measures. Only patients at low risk can safely perform sexual activity and receive therapies aimed at improving their sexual function. Risk reduction and lifestyle change, the administration of phosphodiesterase type 5 inhibitors, and testosterone replacement therapy might have a beneficial effect both on erectile function and the risk of novel cardiac events.",
keywords = "Cardiovascular events, Cardiovascular mortality, Coronary artery disease, Erectile dysfunction, Phosphodiesterase type 5 inhibitors",
author = "G. Gandaglia and Alberto Briganti and Piero Montorsi and Alexandre Mottrie and Andrea Salonia and Francesco Montorsi",
year = "2016",
doi = "10.1016/j.eururo.2016.01.054",
language = "English",
journal = "European Urology",
issn = "0302-2838",
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}

TY - JOUR

T1 - Diagnostic and Therapeutic Implications of Erectile Dysfunction in Patients with Cardiovascular Disease

AU - Gandaglia, G.

AU - Briganti, Alberto

AU - Montorsi, Piero

AU - Mottrie, Alexandre

AU - Salonia, Andrea

AU - Montorsi, Francesco

PY - 2016

Y1 - 2016

N2 - Erectile dysfunction (ED) and cardiovascular disease (CVD) share many common pathophysiologic pathways and might be regarded as two different clinical manifestations of the same systemic disease. Consequently, ED and CVD are pathologic conditions that often coexist in the same patient. The urologist plays an important role in the management of ED in patients with a history of cardiovascular events. Therapeutic measures aimed at improving sexual function in CVD patients should be considered only after careful evaluation of the underlying cardiologic condition and assessment of ability to exercise. Sexual activity and treatment of ED might trigger cardiac events in selected patients with preexisting CVD; therefore, proerectile therapies should be administered only to low-risk patients for whom subsequent risk of cardiac events would not be increased. Conversely, men at high risk of CVD should receive cardiologic reassessment and stabilization before attempting sexual activity and receiving ED treatment. Risk reduction and lifestyle changes, administration of phosphodiesterase type 5 inhibitors, and testosterone replacement therapy, as indicated, might provide benefits not only in terms of improving sexual function but also for reducing the risk of future cardiac events. Patient summary: Erectile dysfunction (ED) and cardiovascular disease (CVD) share many pathophysiologic mechanisms and often coexist in the same patient. We evaluated the role of the urologist in the management of ED in patients with preexisting CVD and the impact of measures aimed at improving sexual function on the subsequent risk of cardiac events. The evaluation of the cardiovascular risk associated with sexual activity is mandatory before considering proerectile measures. Only patients at low risk can safely perform sexual activity and receive therapies aimed at improving their sexual function. Risk reduction and lifestyle change, the administration of phosphodiesterase type 5 inhibitors, and testosterone replacement therapy might have a beneficial effect both on erectile function and the risk of novel cardiac events.

AB - Erectile dysfunction (ED) and cardiovascular disease (CVD) share many common pathophysiologic pathways and might be regarded as two different clinical manifestations of the same systemic disease. Consequently, ED and CVD are pathologic conditions that often coexist in the same patient. The urologist plays an important role in the management of ED in patients with a history of cardiovascular events. Therapeutic measures aimed at improving sexual function in CVD patients should be considered only after careful evaluation of the underlying cardiologic condition and assessment of ability to exercise. Sexual activity and treatment of ED might trigger cardiac events in selected patients with preexisting CVD; therefore, proerectile therapies should be administered only to low-risk patients for whom subsequent risk of cardiac events would not be increased. Conversely, men at high risk of CVD should receive cardiologic reassessment and stabilization before attempting sexual activity and receiving ED treatment. Risk reduction and lifestyle changes, administration of phosphodiesterase type 5 inhibitors, and testosterone replacement therapy, as indicated, might provide benefits not only in terms of improving sexual function but also for reducing the risk of future cardiac events. Patient summary: Erectile dysfunction (ED) and cardiovascular disease (CVD) share many pathophysiologic mechanisms and often coexist in the same patient. We evaluated the role of the urologist in the management of ED in patients with preexisting CVD and the impact of measures aimed at improving sexual function on the subsequent risk of cardiac events. The evaluation of the cardiovascular risk associated with sexual activity is mandatory before considering proerectile measures. Only patients at low risk can safely perform sexual activity and receive therapies aimed at improving their sexual function. Risk reduction and lifestyle change, the administration of phosphodiesterase type 5 inhibitors, and testosterone replacement therapy might have a beneficial effect both on erectile function and the risk of novel cardiac events.

KW - Cardiovascular events

KW - Cardiovascular mortality

KW - Coronary artery disease

KW - Erectile dysfunction

KW - Phosphodiesterase type 5 inhibitors

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