Editorial on Erectile Dysfunction as Sentinel for Cardiovascular Disease

Abstract

Erectile dysfunction (ED) affects millions of men worldwide with implications that go far beyond sexual activity. ED is predominantly a vascular disease, frequently coexists with cardiovascular diseases (CVD), and shares common risk factors such as metabolic syndrome, hyperlipidemia, smoking, excessive alcohol consumption, and sedentary behavior (Feldman et al. 2000). ED is now recognized as an early marker of cardiovascular disease, diabetes mellitus, and depression (Tan et al. 2012). It is an important component of the quality of life, but it also confers an independent risk for future cardiovascular events (Araujo et al. 2010; Dong et al. 2011). A usual 2–5-year time period is reported between the onset of ED in men with no known CVD and a cardiovascular event (Gazzaruso et al. 2004; Vlachopoulos et al. 2005; Montorsi et al. 2006). Furthermore, evidence suggests that ED is predictive of peripheral arterial disease and stroke (Polonsky et al. 2009; Ponholzer et al. 2005). It offers to physicians an opportunity for risk assessment (Jackson et al. 2010). Incident ED has a similar or greater predictive value for cardiovascular events as traditional risk factors, such as family history of myocardial infarction, smoking, and hyperlipidemia (Thompson et al. 2005; Araujo et al. 2009). Coronary heart disease is often more severe in patients with ED compared to patients without ED (Montorsi et al. 2003a). For that reason, patients who seek treatment for sexual dysfunction have a high prevalence of CVD that can be live threatening (Salonia et al. 2012).