The Triad of Endothelial Dysfunction, Cardiovascular Disease, and Erectile Dysfunction: Clinical Implications

Research output: Contribution to journalArticle

Abstract

Context: Evidence is accumulating in favor of erectile dysfunction (ED) as a vascular disorder in the vast majority of patients. Endothelial dysfunction is the initial step of the atherosclerotic process involving many vascular districts, including penile and coronary circulation. Objective: To make a holistic and comprehensive approach to the proposed triad of endothelial dysfunction-cardiovascular disease (CVD)-ED and its clinical implications. Evidence acquisition: A MedLine search of the dates January 1980 to July 2008 was performed that included original and review manuscripts articles with focus on anatomic, physiologic, epidemiologic, and clinical outcomes. Evidence synthesis: There is room to consider ED as a marker of early subclinical coronary artery disease (CAD). Moreover, ED is an independent predictor of future cardiovascular (CV) events. Noninvasive tests assessing the endothelium integrity are the flow-mediated dilation of the brachial artery and the circulating endothelial activated cells. Conclusions: The onset of sexual dysfunction should be considered as a marker of subclinical systemic vascular disease and has been found to predict subsequent CV events. It is, therefore, crucial to identify asymptomatic patients with ED who may be at risk of occult CAD. Their early recognition may lead to treatment of risk factors and conditions associated with endothelial dysfunction, hopefully reducing the rate of major CV events.

Original languageEnglish
Pages (from-to)58-66
Number of pages9
JournalEuropean Urology, Supplements
Volume8
Issue number2
DOIs
Publication statusPublished - Jan 2009

Fingerprint

Erectile Dysfunction
Cardiovascular Diseases
Blood Vessels
Coronary Artery Disease
Coronary Circulation
Brachial Artery
Manuscripts
Vascular Diseases
Endothelium
Dilatation
Endothelial Cells

Keywords

  • Cardiovascular disease
  • Endothelial dysfunction
  • Erectile dysfunction

ASJC Scopus subject areas

  • Urology

Cite this

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title = "The Triad of Endothelial Dysfunction, Cardiovascular Disease, and Erectile Dysfunction: Clinical Implications",
abstract = "Context: Evidence is accumulating in favor of erectile dysfunction (ED) as a vascular disorder in the vast majority of patients. Endothelial dysfunction is the initial step of the atherosclerotic process involving many vascular districts, including penile and coronary circulation. Objective: To make a holistic and comprehensive approach to the proposed triad of endothelial dysfunction-cardiovascular disease (CVD)-ED and its clinical implications. Evidence acquisition: A MedLine search of the dates January 1980 to July 2008 was performed that included original and review manuscripts articles with focus on anatomic, physiologic, epidemiologic, and clinical outcomes. Evidence synthesis: There is room to consider ED as a marker of early subclinical coronary artery disease (CAD). Moreover, ED is an independent predictor of future cardiovascular (CV) events. Noninvasive tests assessing the endothelium integrity are the flow-mediated dilation of the brachial artery and the circulating endothelial activated cells. Conclusions: The onset of sexual dysfunction should be considered as a marker of subclinical systemic vascular disease and has been found to predict subsequent CV events. It is, therefore, crucial to identify asymptomatic patients with ED who may be at risk of occult CAD. Their early recognition may lead to treatment of risk factors and conditions associated with endothelial dysfunction, hopefully reducing the rate of major CV events.",
keywords = "Cardiovascular disease, Endothelial dysfunction, Erectile dysfunction",
author = "Piero Montorsi and Ravagnani, {Paolo M.} and Stefano Galli and Ali, {Sarah Ghulam} and Alberto Briganti and Andrea Salonia and Francesco Montorsi",
year = "2009",
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language = "English",
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AU - Montorsi, Piero

AU - Ravagnani, Paolo M.

AU - Galli, Stefano

AU - Ali, Sarah Ghulam

AU - Briganti, Alberto

AU - Salonia, Andrea

AU - Montorsi, Francesco

PY - 2009/1

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N2 - Context: Evidence is accumulating in favor of erectile dysfunction (ED) as a vascular disorder in the vast majority of patients. Endothelial dysfunction is the initial step of the atherosclerotic process involving many vascular districts, including penile and coronary circulation. Objective: To make a holistic and comprehensive approach to the proposed triad of endothelial dysfunction-cardiovascular disease (CVD)-ED and its clinical implications. Evidence acquisition: A MedLine search of the dates January 1980 to July 2008 was performed that included original and review manuscripts articles with focus on anatomic, physiologic, epidemiologic, and clinical outcomes. Evidence synthesis: There is room to consider ED as a marker of early subclinical coronary artery disease (CAD). Moreover, ED is an independent predictor of future cardiovascular (CV) events. Noninvasive tests assessing the endothelium integrity are the flow-mediated dilation of the brachial artery and the circulating endothelial activated cells. Conclusions: The onset of sexual dysfunction should be considered as a marker of subclinical systemic vascular disease and has been found to predict subsequent CV events. It is, therefore, crucial to identify asymptomatic patients with ED who may be at risk of occult CAD. Their early recognition may lead to treatment of risk factors and conditions associated with endothelial dysfunction, hopefully reducing the rate of major CV events.

AB - Context: Evidence is accumulating in favor of erectile dysfunction (ED) as a vascular disorder in the vast majority of patients. Endothelial dysfunction is the initial step of the atherosclerotic process involving many vascular districts, including penile and coronary circulation. Objective: To make a holistic and comprehensive approach to the proposed triad of endothelial dysfunction-cardiovascular disease (CVD)-ED and its clinical implications. Evidence acquisition: A MedLine search of the dates January 1980 to July 2008 was performed that included original and review manuscripts articles with focus on anatomic, physiologic, epidemiologic, and clinical outcomes. Evidence synthesis: There is room to consider ED as a marker of early subclinical coronary artery disease (CAD). Moreover, ED is an independent predictor of future cardiovascular (CV) events. Noninvasive tests assessing the endothelium integrity are the flow-mediated dilation of the brachial artery and the circulating endothelial activated cells. Conclusions: The onset of sexual dysfunction should be considered as a marker of subclinical systemic vascular disease and has been found to predict subsequent CV events. It is, therefore, crucial to identify asymptomatic patients with ED who may be at risk of occult CAD. Their early recognition may lead to treatment of risk factors and conditions associated with endothelial dysfunction, hopefully reducing the rate of major CV events.

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KW - Endothelial dysfunction

KW - Erectile dysfunction

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