Assessment of cardiovascular risk in patients with erectile dysfunction: focus on the diabetic patient.
Erectile dysfunction (ED) is commonly associated with risk factors for cardiovascular disease, including diabetes. The prevalence of ED in diabetic patients is high--about 75% of diabetic men 60 yr of age or older had ED in one study. Endothelial dysfunction, accelerated atherosclerosis, and diabetic neuropathy likely contribute to ED in diabetics. As silent ischemia is common in the diabetic patient, and diabetes is now often thought of as a coronary heart disease risk equivalent, diabetic men seeking therapy for ED may be considered candidates for exercise stress testing. Phosphodiesterase 5 (PDE5) inhibitors improve erectile function in diabetic men with ED; however, efficacy rates may be somewhat lower than in nondiabetic men. Studies to date have suggested that PDE5 inhibitors per se do not cause an increase in myocardial infarction rates in men being treated for ED.
Kloner
Robert A
RA
Heart Institute, Good Samaritan Hospital, and Cardiovascular Division, Keck School of Medicine at University of Southern California, Los Angeles, CA 90017, USA. rkloner@goodsam.org
D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000037:antagonists & inhibitors; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000150:complications* / Q000209:etiology*; D003327:Coronary Disease / Q000150:complications; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; D048909:Diabetes Complications; D007172:Erectile Dysfunction / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors
D010726:Phosphodiesterase Inhibitors; D015106:3',5'-Cyclic-GMP Phosphodiesterases; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; C517381:PDE5A protein, human