title: [Drug treatment of erection disorders in patients with cardiovascular disease].
abstract: Erectile dysfunction is a frequent condition in cardiovascular patients. Since the arrival of oral erection-supporting medication, patients want to know how safe sexual activity is in cardiovascular disease in general and during use of erection-supporting medication in particular. Sexual intercourse with a steady partner causes no more cardiovascular risk than normal daily activities such as ironing, 2 kilometers of walking without climbing, paperhanging, playing golf or gardening. The relative risk of myocardial infarction during sexual activity is not significantly higher than for healthy persons. The incidence of cardiovascular morbidity and mortality is not higher among users of sildenafil. Sildenafil is contraindicated in patients using long-acting nitrates or who may need to use short-acting nitrates, because the combination may cause a sharp fall of the blood pressure. No interactions have been observed with beta-receptor blockers, calcium antagonists, thiazide and loop diuretics and ACE inhibitors. Before prescribing a symptomatic (pharmaceutical) treatment for patients with an erection disorder, attention should be given tot the sexological, psychological and medical backgrounds of the disorder. Secondary prevention of atherosclerotic risk factors is also important: regulation of blood pressure and blood sugar level, hyperlipidaemia and obesity, as well as a change of lifestyle (giving up smoking, adapting of diet and more physical exertion). Patients with a very low cardiac capacity should be advised to refrain from treatment of the erection disorder.
authors.affiliation: Universitair Medisch Centrum St Radbond, afd. Urologie, Postbus 9101, 6500 HB Nijmegen. e.meuleman@mailbox.kun.nl
authors.forename: E J
authors.initials: EJ
authors.lastname: Meuleman
authors.forename: J H
authors.initials: JH
authors.lastname: Kingma
mesh_terms: D002318:Cardiovascular Diseases / Q000150:complications* / Q000188:drug therapy; D000075202:Contraindications; D004347:Drug Interactions; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007548:Isosorbide Dinitrate / Q000493:pharmacokinetics; D008297:Male; D009426:Netherlands; D020030:Nitric Oxide Donors / Q000494:pharmacology / Q000627:therapeutic use; D005996:Nitroglycerin / Q000494:pharmacology; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones
chemical_list: D020030:Nitric Oxide Donors; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate; D005996:Nitroglycerin; D007548:Isosorbide Dinitrate
vernacular_title: Medicamenteuze behandeling van erectiestoornissen bij cardiovasculair belaste patiënten.